High parity (≥5 full-term pregnancies) acting synergistically with HPV infection to incre...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`RF-REPRODUCTIVE-HIGH-PARITY-CERVICAL-PREVENTION`
Тип	Тривожна ознака
Статус	переглянуто 2026-05-19 \| очікує клінічного підпису
Хвороби	`DIS-CERVICAL`
Джерела	`SRC-NCCN-CERVICAL-2025` `SRC-USPSTF-CERVICAL-2018`

Походження тривожної ознаки

Визначення	High parity (≥5 full-term pregnancies) acting synergistically with HPV infection to increase cervical cancer risk approximately 2- to 4-fold versus nulliparous HPV-positive women (IARC multi-centre pooled case-control studies; Muñoz et al. Lancet 2002). Hypothesized mechanisms: hormonal exposure (high parity prolongs estrogen + progesterone exposure), maintenance of the transformation zone on the ectocervix (more accessible to HPV), traumatic effects of repeated vaginal delivery, immunosuppression of pregnancy. Important in low-resource settings where HPV vaccination coverage is incomplete and cervical screening infrastructure is limited (sub-Saharan Africa, parts of South Asia, rural Latin America). In well-screened HPV- vaccinated populations the residual contribution is modest. Prevention- persona RedFlag (§20 v0.3 reproductive expansion).
Клінічний напрям	investigate
Категорія	other

Логіка спрацьовування

{
  "any_of": [
    {
      "finding": "parity_ge_5_full_term",
      "value": true
    },
    {
      "finding": "high_parity_with_hpv_positive",
      "value": true
    }
  ],
  "type": "lab_value"
}

Нотатки

Prevention-persona RedFlag for high-parity cervical risk amplifier in HPV-positive women. Counseling: adherence to cervical screening per USPSTF/WHO age-and-method schedule; catch-up HPV vaccination through age 45 per ACIP shared-decision; smoking cessation (synergistic risk). STUB pending two-Co-Lead signoff per CHARTER §6.1 dev-mode.

Де використовується

Indications

IND-REPRODUCTIVE-HIGH-PARITY-CERVICAL-PREVENTION-OBSERVATION - IND-REPRODUCTIVE-HIGH-PARITY-CERVICAL-PREVENTION-OBSERVATION
IND-REPRODUCTIVE-HIGH-PARITY-CERVICAL-PREVENTION-SURVEILLANCE - IND-REPRODUCTIVE-HIGH-PARITY-CERVICAL-PREVENTION-SURVEILLANCE