Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen K, Denmark.
Vaccine. 2012 Feb 14;30(8):1425-33. doi: 10.1016/j.vaccine.2011.11.097. Epub 2011 Dec 7.
Cervical screening has helped decrease the incidence of cervical cancer, but the disease remains a burden for women. Human Papillomavirus (HPV) vaccination is now a promising tool for control of cervical cancer. Nordic countries (Denmark, Finland, Greenland, Iceland, Norway and Sweden) are relatively wealthy with predominantly publicly paid health care systems. The aim of this paper was to provide an update of the current status of introduction of HPV vaccine into the childhood vaccination programs in this region.
Data on cervical cancer, cervical screening programs, childhood immunization and HPV vaccination programs for Nordic countries were searched via PubMed and various organizations. We furthermore contacted selected experts for information.
The incidence of cervical cancer is highest in Greenland (25 per 100,000, age standardized, World Standard Population, ASW) and lowest in Finland (4 per 100,000 ASW) and rates in the other Nordic countries vary between 7 and 11 per 100,000 ASW. Greenland and Denmark were first to introduce HPV vaccination, followed by Norway. Vaccination programs are underway in Sweden and Iceland, while Finland has just recently recommended introduction of vaccination. HPV vaccination has been intensively debated, in particular in Denmark and Norway.
In Nordic countries with a moderate risk of cervical cancer and a publicly paid health care system, the introduction of HPV vaccination was a priority issue. Many players became active, from the general public to health professionals, special interest groups, and the vaccine manufacturers. These seemed to prioritize different health care needs and weighed differently the uncertainty about the long-term effects of the vaccine.
HPV vaccination posed a pressure on public health authorities to consider the evidence for and against it, and on politicians to weigh the wish for cervical cancer protection against other pertinent health issues.
宫颈筛查有助于降低宫颈癌的发病率，但这种疾病仍然是女性的负担。人乳头瘤病毒（HPV）疫苗接种现在是控制宫颈癌的一种有前途的工具。北欧国家（丹麦、芬兰、格陵兰、冰岛、挪威和瑞典）相对富裕，拥有主要由公共支付的医疗保健系统。本文旨在提供该地区 HPV 疫苗引入儿童免疫接种计划的最新情况。
通过 PubMed 和各种组织搜索了关于北欧国家宫颈癌、宫颈筛查计划、儿童免疫和 HPV 疫苗接种计划的数据。我们还联系了选定的专家以获取信息。
宫颈癌发病率在格陵兰最高（25/10 万，年龄标准化，世界标准人口，ASW），在芬兰最低（4/10 万 ASW），其他北欧国家的发病率在 7 至 11/10 万 ASW 之间。格陵兰和丹麦率先引入 HPV 疫苗接种，其次是挪威。瑞典和冰岛正在开展疫苗接种计划，而芬兰最近才建议引入疫苗接种。HPV 疫苗接种引起了广泛的讨论，特别是在丹麦和挪威。
在宫颈癌风险适中且拥有公共支付医疗保健系统的北欧国家，引入 HPV 疫苗接种是一个优先事项。从公众到卫生专业人员、利益集团和疫苗制造商，许多参与者都变得活跃起来。这些人似乎优先考虑不同的医疗保健需求，并对疫苗的长期效果的不确定性进行不同的权衡。
HPV 疫苗接种给公共卫生当局带来了考虑其利弊的压力，也给政治家们带来了权衡宫颈癌保护愿望与其他相关健康问题的压力。
