Biswas A
Department of Obstetrics & Gynaecology, National University Hospital, National University of Singapore, Singapore.
J Indian Med Assoc. 2000 Feb;98(2):53-5.
Epidemiologic studies have consistently shown that the most important risk factor for cervical cancer relates to sexual activity and a sexually transmitted agent, probably a virus, is the principal causative agent. In recent years, much attention has been focused on the human papillomavirus (HPV) as the causative agent. The compelling epidemiologic evidence of the role of HPV in cervical cancer is complemented by equally strong data on the role of oncoproteins E6 and E7 of high-risk HPV strains in the molecular pathogenesis of cervical cancer. Incidence and mortality from cervical cancer have been decreasing steadily in most developed countries, but is the leading female cancer in developing countries. This variation in incidence is explicable in terms of differing levels of risk behaviour and population screening facilities and uptake. With better understanding of the aetiopathogenesis, vaccination against HPV is becoming a reality. This may be particularly useful in developing countries, where it is proving difficult to implement effective screening programmes.
流行病学研究一直表明，宫颈癌最重要的风险因素与性行为有关，一种性传播病原体（可能是病毒）是主要致病因素。近年来，人乳头瘤病毒（HPV）作为致病因素受到了广泛关注。HPV在宫颈癌中作用的有力流行病学证据，得到了关于高危HPV毒株的癌蛋白E6和E7在宫颈癌分子发病机制中作用的同样有力数据的补充。在大多数发达国家，宫颈癌的发病率和死亡率一直在稳步下降，但在发展中国家，宫颈癌是女性主要癌症。发病率的这种差异可以通过不同的风险行为水平以及人群筛查设施和接受程度来解释。随着对病因发病机制的更好理解，HPV疫苗接种正在成为现实。这在发展中国家可能特别有用，因为在这些国家实施有效的筛查计划证明很困难。
