Predicting depressive symptoms among Chinese college students using recurrent neural networks with longitudinal data.

Cervical cancer is a leading cause of cancer-related mortality among women, disproportionately affecting those in low- and middle-income countries (LMICs). The disease is primarily caused by persistent infection with high-risk human papillomavirus (HPV), a common sexually transmitted infection. While most HPV infections are cleared naturally by the immune system, persistent infections can lead to precancerous lesions, which may progress to invasive cervical cancer if left untreated []. Women living with human immunodeficiency virus (HIV) are particularly vulnerable, with studies indicating that they have a six-fold increased risk of developing cervical cancer compared to HIV-negative women []. This association is primarily due to the immunosuppressive effects of HIV, which reduce the body’s ability to clear HPV infections and control neoplastic transformation. The late detection of these lesions is often linked to poor survival rates following surgical or radiotherapeutic interventions. While some HPV infections and associated precancerous lesions regress spontaneously, chronic infections pose a significant risk of progression to invasive cervical cancer []. The World Health Organization (WHO) recommends a multi-pronged approach to cervical cancer prevention, emphasizing HPV vaccination for girls aged 9–14 years, regular screening for early detection, and timely treatment of precancerous lesions []. In resource-limited settings, WHO advocates for visual inspection with acetic acid (VIA) as a cost-effective and accessible screening method [, ]. VIA allows for immediate identification of abnormalities and facilitates prompt treatment, thereby reducing the risk of progression to cervical cancer []. Despite these recommendations, the burden of cervical cancer remains disproportionately high in Sub-Saharan Africa, where an estimated 80% of cases are diagnosed at advanced stages, limiting treatment options and survival outcomes []. Recent WHO guideline updates for women living with HIV recommend initiating cervical cancer screening at age 25, with repeat screening every 3 to 5 years. HPV DNA testing is increasingly emphasized as the preferred primary screening modality, with triage strategies using VIA, cytology, or colposcopy for women who test positive. This approach aims to improve early detection and reduce cervical cancer incidence and mortality more effectively than VIA alone [, ]. Cervical cancer remains a significant public health concern in Ethiopia, ranking as the second most common cancer among women. According to the International Agency for Research on Cancer (IARC), in 2020, there were approximately 7,445 new cases of cervical cancer in Ethiopia, with 5,338 (71.7%) deaths attributed to the disease []. However, these figures likely underrepresent the actual burden due to low awareness, limited access to screening and treatment services, and the absence of a comprehensive national cancer registry []. Several risk factors contribute to the high magnitude of cervical cancer in Ethiopia, including persistent HPV infection, tobacco smoking, high parity, prolonged hormonal contraceptive use, and co-infection with HIV []. Women living with HIV face an elevated risk of developing both precancerous lesions and invasive cervical cancer due to immune suppression []. Despite the availability of effective preventive measures, cervical cancer screening coverage remains alarmingly low. Globally, screening coverage in low-income countries is estimated at 19%, compared to 63% in high-income countries []. In Ethiopia, coverage is even lower, with some regions reporting screening rates below 1%, particularly in rural and conflict-affected settings [].