{"title":"尽早采用创新的 HPV 预防策略:缩小宫颈癌的差距。","authors":"Ishika Mahajan, Amogh Kadam, Lucy McCann, Aruni Ghose, Katie Wakeham, Navjot Singh Dhillon, Susannah Stanway, Stergios Boussios, Soirindhri Banerjee, Ashwini Priyadarshini, Bhawna Sirohi, Julie S Torode, Swarupa Mitra","doi":"10.3332/ecancer.2024.1762","DOIUrl":null,"url":null,"abstract":"<p><p>Cervical cancer (CC) is one of the highest prevailing causes of female cancer-related mortality globally. A significant discrepancy in incidence has been noted between high and low-middle-income countries. The origins of CC have been accredited to the human papillomavirus (HPV) with serotypes 16 and 18 being the most prevalent. HPV vaccines, with 90%-97% efficacy, have proven safe and currently function as the primary prevention method. In addition, secondary prevention by timely screening can potentially increase the 5-year survival rate by >90%. High-precision HPV DNA testing has proven to be both highly sensitive and specific for early detection and is advocated by the WHO. Lack of public awareness, poor screening infrastructure and access to vaccines, socio-cultural concerns, along with economic, workforce-associated barriers and the presence of marginalised communities unable to access services have contributed to a continued high incidence. This article comprehensively analyses the efficacy, coverage, benefits and cost-effectiveness of CC vaccines and screening strategies including the transition from cytological screening to HPV self-sampling, while simultaneously exploring the real-world disparities in their feasibility. Furthermore, it calls for the implementation of population-based approaches that address the obstacles faced in approaching the WHO 2030 targets for CC elimination.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"18 ","pages":"1762"},"PeriodicalIF":1.2000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489098/pdf/","citationCount":"0","resultStr":"{\"title\":\"Early adoption of innovation in HPV prevention strategies: closing the gap in cervical cancer.\",\"authors\":\"Ishika Mahajan, Amogh Kadam, Lucy McCann, Aruni Ghose, Katie Wakeham, Navjot Singh Dhillon, Susannah Stanway, Stergios Boussios, Soirindhri Banerjee, Ashwini Priyadarshini, Bhawna Sirohi, Julie S Torode, Swarupa Mitra\",\"doi\":\"10.3332/ecancer.2024.1762\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Cervical cancer (CC) is one of the highest prevailing causes of female cancer-related mortality globally. A significant discrepancy in incidence has been noted between high and low-middle-income countries. The origins of CC have been accredited to the human papillomavirus (HPV) with serotypes 16 and 18 being the most prevalent. HPV vaccines, with 90%-97% efficacy, have proven safe and currently function as the primary prevention method. In addition, secondary prevention by timely screening can potentially increase the 5-year survival rate by >90%. High-precision HPV DNA testing has proven to be both highly sensitive and specific for early detection and is advocated by the WHO. Lack of public awareness, poor screening infrastructure and access to vaccines, socio-cultural concerns, along with economic, workforce-associated barriers and the presence of marginalised communities unable to access services have contributed to a continued high incidence. This article comprehensively analyses the efficacy, coverage, benefits and cost-effectiveness of CC vaccines and screening strategies including the transition from cytological screening to HPV self-sampling, while simultaneously exploring the real-world disparities in their feasibility. Furthermore, it calls for the implementation of population-based approaches that address the obstacles faced in approaching the WHO 2030 targets for CC elimination.</p>\",\"PeriodicalId\":11460,\"journal\":{\"name\":\"ecancermedicalscience\",\"volume\":\"18 \",\"pages\":\"1762\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489098/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ecancermedicalscience\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3332/ecancer.2024.1762\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ecancermedicalscience","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3332/ecancer.2024.1762","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
宫颈癌(CC)是全球女性癌症相关死亡率最高的主要原因之一。高收入国家和中低收入国家之间的发病率差异很大。宫颈癌起源于人类乳头瘤病毒(HPV),其中血清型 16 和 18 最为流行。HPV 疫苗的有效率为 90%-97%,已被证明是安全的,目前是主要的预防方法。此外,通过及时筛查进行二级预防有可能将 5 年存活率提高 90%以上。高精度人乳头瘤病毒 DNA 检测已被证明对早期检测具有高度敏感性和特异性,并得到了世界卫生组织的倡导。公众意识的缺乏、筛查基础设施的落后、疫苗的缺乏、社会文化方面的担忧、经济和劳动力方面的障碍以及无法获得服务的边缘化群体的存在,都是导致发病率居高不下的原因。本文全面分析了CC疫苗和筛查策略(包括从细胞学筛查过渡到HPV自我采样)的功效、覆盖范围、益处和成本效益,同时探讨了其可行性在现实世界中的差异。此外,该报告还呼吁实施基于人群的方法,以解决在实现世卫组织 2030 年消除 CC 目标过程中所面临的障碍。
Early adoption of innovation in HPV prevention strategies: closing the gap in cervical cancer.
Cervical cancer (CC) is one of the highest prevailing causes of female cancer-related mortality globally. A significant discrepancy in incidence has been noted between high and low-middle-income countries. The origins of CC have been accredited to the human papillomavirus (HPV) with serotypes 16 and 18 being the most prevalent. HPV vaccines, with 90%-97% efficacy, have proven safe and currently function as the primary prevention method. In addition, secondary prevention by timely screening can potentially increase the 5-year survival rate by >90%. High-precision HPV DNA testing has proven to be both highly sensitive and specific for early detection and is advocated by the WHO. Lack of public awareness, poor screening infrastructure and access to vaccines, socio-cultural concerns, along with economic, workforce-associated barriers and the presence of marginalised communities unable to access services have contributed to a continued high incidence. This article comprehensively analyses the efficacy, coverage, benefits and cost-effectiveness of CC vaccines and screening strategies including the transition from cytological screening to HPV self-sampling, while simultaneously exploring the real-world disparities in their feasibility. Furthermore, it calls for the implementation of population-based approaches that address the obstacles faced in approaching the WHO 2030 targets for CC elimination.