Murillo Raul, Almonte Maribel, Pereira Ana, Ferrer Elena, Gamboa Oscar A, Jerónimo José, Lazcano-Ponce Eduardo
Division of Research and Public Health, Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia.
Vaccine. 2008 Aug 19;26 Suppl 11:L37-48. doi: 10.1016/j.vaccine.2008.06.013.
Latin America and the Caribbean (LAC) have a significant burden of cervical cancer. Prophylactic human papillomavirus (HPV) vaccines are an opportunity for primary prevention and new screening methods, such as new HPV DNA testing, are promising alternatives to cytology screening that should be analyzed in the context of regional preventive programs. Cytology-based screening programs have not fulfilled their expectations and coverage does not sufficiently explain the lack of impact on screening in LAC. While improved evaluation of screening programs is necessary to increase the impact of screening on the reduction of incidence and mortality, other programmatic aspects will need to be addressed such as follow-up of positive tests and quality control. The implementation of new technologies might enhance screening performance and reduce mortality in the region. The characteristics, performance and impact of cervical cancer screening programs in LAC are reviewed in this article.
拉丁美洲和加勒比地区(LAC)宫颈癌负担沉重。预防性人乳头瘤病毒(HPV)疫苗是一级预防的契机,而新的筛查方法,如新的HPV DNA检测,是细胞学筛查的有前景的替代方法,应在区域预防计划的背景下进行分析。基于细胞学的筛查计划未达预期,覆盖率也不足以解释其在LAC地区筛查效果不佳的原因。虽然有必要改进筛查计划的评估以增强筛查对降低发病率和死亡率的影响,但还需解决其他计划方面的问题,如阳性检测结果的随访和质量控制。新技术的实施可能会提高该地区的筛查效果并降低死亡率。本文对LAC地区宫颈癌筛查计划的特点、效果和影响进行了综述。