New Trends in the Detection of Gynecological Precancerous Lesions and Early-Stage Cancers

SIMPLE SUMMARY: This review deals with the prospects of early diagnostics in cervical, endometrial, and ovarian cancers. Progress in cancer research has enabled the rapid development of cancer diagnostics, treatments, and preventions. Indeed, the current situation in genital tract tumors reflects the trend in contemporary oncology that emphasizes cancer prevention and early diagnostics. Cervical cancer screening using cytological examination has a long tradition, is highly effective, and is now being complemented with HPV triage, allowing early diagnostics even in precancerous stages due to the relative ease of accessibility of the uterine cervix. Moreover, vaccination against HPV, which is major cause of cervical cancer, is now recommended for both girls and boys at an early age. In contrast, endometrial and, particularly, ovarian cancers are poorly accessible by sampling, and neither prevention nor screening methods readily exist. Thus, other options leading to their early diagnostics are discussed, in which circulating biomarkers play key roles. ABSTRACT: The prevention and early diagnostics of precancerous stages are key aspects of contemporary oncology. In cervical cancer, well-organized screening and vaccination programs, especially in developed countries, are responsible for the dramatic decline of invasive cancer incidence and mortality. Cytological screening has a long and successful history, and the ongoing implementation of HPV triage with increased sensitivity can further decrease mortality. On the other hand, endometrial and ovarian cancers are characterized by a poor accessibility to specimen collection, which represents a major complication for early diagnostics. Therefore, despite relatively promising data from evaluating the combined effects of genetic variants, population screening does not exist, and the implementation of new biomarkers is, thus, necessary. The introduction of various circulating biomarkers is of potential interest due to the considerable heterogeneity of cancer, as highlighted in this review, which focuses exclusively on the most common tumors of the genital tract, namely, cervical, endometrial, and ovarian cancers. However, it is clearly shown that these malignancies represent different entities that evolve in different ways, and it is therefore necessary to use different methods for their diagnosis and treatment.