全球消除宫颈癌的挑战和机遇:我们如何为其他癌症建立一个模型?

Q1 Medicine
Clement Adebamowo, Paolo Giorgi Rossi, Philip E Castle
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引用次数: 0

摘要

尽管可以通过人乳头瘤病毒(HPV)疫苗接种和基于HPV的筛查进行有效预防,但宫颈癌仍然是全球妇女癌症相关死亡的主要原因。这篇综述探讨了宫颈癌预防的最新技术,检查了它们的功效、实施挑战和全球可及性差异。预防性人乳头瘤病毒疫苗接种和人乳头瘤病毒DNA检测已证明在降低宫颈癌发病率方面非常有效,但它们的普及程度仍然不均衡,特别是在疾病负担最重的低收入和中等收入国家。障碍包括基础设施限制、劳动力短缺、社会文化障碍和相互竞争的卫生优先事项。单剂疫苗接种、儿童早期免疫、自我抽样和筛查治疗方法等战略为扩大可及性提供了有希望的途径。在高收入国家(HICs), HPV疫苗接种率较高,筛查系统更完善,感染风险降低和HPV检测的高阴性预测值支持向筛查强化转变。精确预防框架——利用生物标志物、基因分型和人工智能——为提高准确性和效率提供了进一步的机会。审查还强调了加强卫生系统、国际合作和政策支持对实现世卫组织消除宫颈癌的90-70-90目标的重要性。此外,宫颈癌预防方面的创新——如分散筛查、移动健康平台和任务转移——为改进其他癌症的一级和二级预防策略提供了一个有价值的模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Challenges and Opportunities for Global Cervical Cancer Elimination: How Can We Build a Model for Other Cancers?

Cervical cancer remains a leading cause of cancer-related death among women globally, despite the availability of effective prevention through human papillomavirus (HPV) vaccination and HPV-based screening. This review explores the state-of-the-art technologies for cervical cancer prevention, examining their efficacy, implementation challenges, and global disparities in access. Prophylactic HPV vaccination and HPV DNA testing have demonstrated high efficacy in reducing cervical cancer incidence, yet their uptake remains uneven-especially in low- and middle-income countries (LMICs), where the disease burden is greatest. Barriers include infrastructure limitations, workforce shortages, sociocultural obstacles, and competing health priorities. Strategies such as single-dose vaccination, early childhood immunization, self-sampling, and screen-and-treat approaches offer promising pathways to expand access. In high-income countries (HICs), where HPV vaccine uptake is higher and screening systems are more established, the reduced risk of infection and high negative predictive value of HPV testing support a shift toward screening deintensification. Precision prevention frameworks-leveraging biomarkers, genotyping, and artificial intelligence-offer further opportunities to enhance accuracy and efficiency. The review also underscores the importance of health system strengthening, international collaboration, and policy support to achieve the WHO's 90-70-90 targets for cervical cancer elimination. Moreover, innovations developed for cervical cancer prevention-such as decentralized screening, mobile health platforms, and task-shifting-offer a valuable model for improving strategies for primary and secondary prevention of other cancers.

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期刊介绍: The Ed Book is a National Library of Medicine–indexed collection of articles written by ASCO Annual Meeting faculty and invited leaders in oncology. Ed Book was launched in 1985 to highlight standards of care and inspire future therapeutic possibilities in oncology. Published annually, each volume highlights the most compelling research and developments across the multidisciplinary fields of oncology and serves as an enduring scholarly resource for all members of the cancer care team long after the Meeting concludes. These articles address issues in the following areas, among others: Immuno-oncology, Surgical, radiation, and medical oncology, Clinical informatics and quality of care, Global health, Survivorship.
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