Unit for Gynaecological Oncology, Stellenbosch University and Tygerberg Hospital, PO Box 19063, Tygerberg 7505, South Africa.
Vaccine. 2012 Sep 7;30 Suppl 3:C28-34. doi: 10.1016/j.vaccine.2012.03.032.
South Africa has a high incidence of cervical cancer, with an age-standardised rate of approximately 27 per 100,000. In 2000, South Africa launched a national screening programme for cervical cancer prevention, offering three Papanicolaou smears per lifetime starting after the age of 30 with 10-year intervals. However, in the public sector, this national screening programme has not been implemented widely. Vaccination would offer the best primary prevention. Currently there are two HPV vaccines registered in South Africa: the bivalent vaccine Cervarix, containing VLP antigens for oncogenic HPV types 16 and 18; and the quadrivalent vaccine Gardasil, containing VLP antigens for HPV types 16 and 18, as well as non-oncogenic HPV types 6 and 11, which are the most common types causing genital warts. The vaccines are recommended for prophylactic use, and should ideally be given before exposure to HPV, which is before sexual debut, to girls aged 11-12 years. Possible routes for delivering the HPV vaccine could be either the routine EPI programme at the age of 12 years when dT is being administered, or through the school system, e.g. to girls attending grade 5 or 6.
南非的宫颈癌发病率较高，年龄标准化发病率约为每 10 万人 27 例。2000 年，南非启动了一项全国性的宫颈癌预防筛查计划，为 30 岁以后的人群提供三次巴氏涂片检查，每 10 年一次。然而，在公共部门，这一全国性的筛查计划并没有得到广泛实施。疫苗接种将提供最佳的初级预防。目前，南非有两种 HPV 疫苗注册：二价疫苗 Cervarix，包含针对致癌 HPV 型 16 和 18 的 VLP 抗原；以及四价疫苗 Gardasil，包含针对 HPV 型 16 和 18 的 VLP 抗原，以及非致癌 HPV 型 6 和 11，它们是引起生殖器疣的最常见类型。疫苗推荐用于预防性使用，理想情况下应在 HPV 暴露之前，即初次性行为之前，为 11-12 岁的女孩接种。HPV 疫苗的接种途径可能是在常规 EPI 计划中，在接种 dT 的 12 岁时进行，或者通过学校系统，例如为 5 年级或 6 年级的女孩接种。
