Screening Group, International Agency for Research on Cancer, Lyon, France.
Indian J Med Res. 2009 Sep;130(3):322-6.
Four-fifths of the cervical cancer burden in the world is experienced in developing countries. HPV genotypes 16 and 18 account for 70 per cent of cervical cancers and currently available vaccines targeting these two types confer a high degree of protection against HPV 16/18 infection and related cervical precancerous lesions. However, widespread implementation of HPV vaccination programs are challenged by the unaffordable high costs of the vaccines and the lack of effective vaccine delivery platforms for sexually naïve girls. Other unresolved issues include long-term protection, cross-protection against HPV types not included in the vaccine and whether booster doses will be needed. Sensitivities associated with a vaccine preventing a sexually transmitted infection in girls, lack of awareness, public demand and political will, lack of coordination between cancer control, sexual and reproductive health and vaccine delivery services are additional challenges. Reduced costs, simple vaccine regimes and strengthening vaccine delivery platforms for adolescents should eventually facilitate HPV vaccine introduction in developing countries.
全世界五分之四的宫颈癌负担发生在发展中国家。HPV 基因型 16 和 18 占宫颈癌的 70%，目前针对这两种类型的疫苗可高度预防 HPV 16/18 感染和相关的宫颈前病变。然而，HPV 疫苗接种计划的广泛实施受到疫苗高昂费用的限制，以及缺乏针对性幼稚女孩的有效疫苗接种平台。其他未解决的问题包括长期保护、对疫苗未涵盖的 HPV 类型的交叉保护，以及是否需要加强剂量。疫苗预防女孩中性传播感染的敏感性、意识不足、公众需求和政治意愿、癌症控制、性健康和生殖健康以及疫苗接种服务之间缺乏协调等问题也带来了挑战。降低成本、简化疫苗接种方案以及加强青少年疫苗接种平台，最终应有助于发展中国家引入 HPV 疫苗。
