Eluf-Neto J, Nascimento C M
Department of Preventive Medicine, School of Medicine, University of São Paulo, São Paulo, Brazil.
Semin Oncol. 2001 Apr;28(2):188-97. doi: 10.1053/sonc.2001.21966.
Cervical cancer is a common cause of morbidity and mortality in developing countries. In Latin America, the incidence rates in several cities are among the highest worldwide, probably due to a high frequency of risk factors and/or a low screening coverage for cervical cancer. Epidemiologic studies conducted in Latin America (and some in the Caribbean), that have investigated the main risk factors for the disease, as well as screening coverage by Papanicolaou (Pap) smear, were reviewed. The prevalence of human papillomavirus (HPV) infection among women with negative Pap smears does not seem to explain the risk observed in Latin American countries. Results of some studies have suggested that reproductive factors and male sexual behavior might be responsible, at least partially, for the high occurrence of cervical cancer in Latin America. Concerning cytology screening, many women have a smear taken regularly (some every year). However, a significant proportion of women, probably those with a high risk of cancer of the cervix, have never had a Pap test. To reduce cervical cancer in these countries, screening programs in Latin America should have a wider coverage, especially reaching those women at higher risk. Semin Oncol 28:188-197.
宫颈癌是发展中国家发病和死亡的常见原因。在拉丁美洲，几个城市的发病率位居世界前列，这可能是由于危险因素的高频率存在和/或宫颈癌筛查覆盖率较低。本文综述了在拉丁美洲（以及加勒比地区的一些研究）开展的流行病学研究，这些研究调查了该疾病的主要危险因素以及巴氏涂片检查的筛查覆盖率。在巴氏涂片检查结果为阴性的女性中，人乳头瘤病毒（HPV）感染的流行率似乎无法解释在拉丁美洲国家观察到的风险。一些研究结果表明，生殖因素和男性性行为可能至少部分导致了拉丁美洲宫颈癌的高发病率。关于细胞学筛查，许多女性定期进行涂片检查（有些女性每年检查一次）。然而，相当一部分女性，可能是那些宫颈癌高危女性，从未进行过巴氏试验。为了在这些国家减少宫颈癌的发生，拉丁美洲的筛查项目应该有更广泛的覆盖范围，特别是要惠及那些高危女性。《肿瘤学 Seminars》28:188 - 197。
