HPV Research Group, Department of Obstetrics and Gynecology, School of Medicine, Cardiff University, Health Park, Cardiff, CF14 4XN, UK.
Minerva Med. 2009 Dec;100(6):503-23.
Cervical cancer is the second most common female cancer with 500000 new cases and 290000 deaths occurring worldwide per annum. Organized cervical screening programs have reduced the incidence and mortality of cervical cancer. However, in developing countries scarce resources, poverty, lack of infrastructure and disenfranchisement of women have been major hurdles in the effective implementation of routine screening programmes. As a result, 83% of cervical cancers still occur in the developing countries and account for 15% of all female cancers. Epidemiological studies have established a causative role of Human Papillomavi-rus (HPV) infection in the development of cervical cancer. The development and implementation of a prophylactic HPV vaccine will have a major impact on preventing this global disease. However, long-term surveillance of the HPV vaccination program will be required to confirm the expected reduction in cervical cancer incidence. This article reviews the role of HPV in the development of cancer and the burden of HPV related cancers; types and pharmacokinetics of HPV vaccines; challenges and issues in implementing vaccination programmes; screening in the developing and developed countries and screening options in the post-vaccination era.
宫颈癌是女性第二大常见癌症，全球每年新发病例 50 万例，死亡 29 万例。有组织的宫颈癌筛查计划已经降低了宫颈癌的发病率和死亡率。然而，在发展中国家，资源匮乏、贫困、基础设施缺乏以及剥夺妇女权利等问题一直是常规筛查计划有效实施的主要障碍。因此，83%的宫颈癌仍发生在发展中国家，占所有女性癌症的 15%。流行病学研究已经确立了人乳头瘤病毒（HPV）感染在宫颈癌发展中的致病作用。预防性 HPV 疫苗的开发和应用将对预防这一全球性疾病产生重大影响。然而，需要对 HPV 疫苗接种计划进行长期监测，以确认预期的宫颈癌发病率降低。本文综述了 HPV 在癌症发展中的作用以及 HPV 相关癌症的负担；HPV 疫苗的类型和药代动力学；在发展中国家和发达国家实施疫苗接种计划的挑战和问题；以及在接种疫苗后的时代的筛查选择。
