Fiander A N
Department of Obstetrics & Gynaecology, Wales College of Medicine Cardiff University, Cardiff, CF14 4XN, Wales.
Womens Health (Lond). 2011 Jan;7(1):121-32. doi: 10.2217/whe.10.74.
In this article we aim to draw attention to the burden of cervical cancer in Africa for reproductive health and review strategies for prevention, including appropriate noncytology-based cervical screening and prophylactic human papillomavirus vaccination. We consider the heavy burden of disease attributable to human papillomavirus infection borne by developing countries, particularly in Africa. Following identification of the human papillomavirus as the infectious etiological agent and elucidation of the long natural history of cervical neoplasia, cervical cancer is now one of the most preventable of all cancers. Opportunities for primary prevention by prophylactic vaccination and secondary prevention by appropriate cervical screening are discussed, together with the importance of population coverage. Qualitative work on attitudes towards cervical cancer prevention, education needs, the creation of an environment for informed choice and uptake are essential aspects of effective prevention programs. Cervical cancer poses a huge health burden in Africa. It is a disease that is eminently preventable given political will, the availability of affordable vaccines, appropriate cervical screening and access to cheap, point-of-care human papillomavirus testing. There are a number of unanswered questions for the prevention of cervical cancer and a need for demonstration projects to address these and further develop prevention strategies.
在本文中，我们旨在提请人们关注宫颈癌对非洲生殖健康造成的负担，并回顾预防策略，包括适当的非细胞学宫颈癌筛查和预防性人乳头瘤病毒疫苗接种。我们考虑到发展中国家，尤其是非洲，因感染人乳头瘤病毒而承受的沉重疾病负担。在确定人乳头瘤病毒为感染性病因并阐明宫颈癌前病变漫长的自然史之后，宫颈癌现已成为所有癌症中最可预防的癌症之一。本文讨论了通过预防性疫苗接种进行一级预防以及通过适当宫颈癌筛查进行二级预防的机会，以及人群覆盖的重要性。关于宫颈癌预防态度、教育需求、营造知情选择和接受环境的定性研究，是有效预防计划的重要方面。宫颈癌给非洲带来了巨大的健康负担。鉴于政治意愿、可负担疫苗的供应、适当的宫颈癌筛查以及获得廉价的即时人乳头瘤病毒检测的机会，这是一种完全可以预防的疾病。在预防宫颈癌方面存在一些未解决的问题，需要开展示范项目来解决这些问题并进一步制定预防策略。
