Department of Microbiology & Infectious Diseases, The Royal Women's Hospital, Melbourne, Victoria, Australia.
Indian J Med Res. 2009 Sep;130(3):311-21.
Cervical cancer is the first cancer to be shown to be 100 per cent attributable to a virus; oncogenic human papillomaviruses (HPV), particularly types 16 and 18, collectively worldwide contribute to 70 per cent squamous cell carcinomas, 85 per cent of adenocarcinomas. Cervical cancer is the second commonest cancer of women, yet largely preventable with high-quality, well-organized screening of the appropriate population. Screening programmes are either nonexistent, or function opportunistically in many poorer countries, resulting in high incidence and mortality. Recently developed, prophylactic HPV vaccines against HPV 16, 18, as cervical cancer preventative vaccines, in phase 3 clinical trials have been shown, to be highly efficacious, safe and immunogenic. With the potential for cross protection against related HPV types, estimates for prevention are in the order of 75 to 80 per cent. Thus a further option exists in the battle to reduce these cancers in women. Challenges however include implementing a vaccination programme with wide coverage to the target populations to be a successful public health tool, integration and maintenance of current screening programmes where they are in existence, the need for reduced costs of the current vaccines, long-term immunogenicity (will there be a need for further doses?), appropriate education messages to the general community, governments, as well as the medical profession.
宫颈癌是首个被证实 100%由病毒引起的癌症；致癌性人乳头瘤病毒（HPV），尤其是 16 型和 18 型，在全球范围内共同导致 70%的鳞状细胞癌和 85%的腺癌。宫颈癌是女性第二大常见癌症，但通过对合适人群进行高质量、组织良好的筛查，大部分是可以预防的。在许多较贫穷的国家，筛查计划要么不存在，要么只是偶发进行，导致发病率和死亡率居高不下。最近开发的预防性 HPV 疫苗针对 HPV 16、18 型，作为宫颈癌预防疫苗，在 3 期临床试验中已显示出高度有效、安全和免疫原性。由于具有针对相关 HPV 型的交叉保护潜力，估计预防效果在 75%至 80%之间。因此，在减少女性癌症方面又有了另一种选择。然而，挑战包括实施广泛覆盖目标人群的疫苗接种计划，以使其成为成功的公共卫生工具，整合和维护现有筛查计划（如果存在的话），降低现有疫苗的成本，长期免疫原性（是否需要进一步接种？），向普通社区、政府以及医疗行业传达适当的教育信息。
