Bősze Péter
Fővárosi Önkormányzat Egyesített Szent István és Szent László Kórház Budapest.
Orv Hetil. 2013 Apr 21;154(16):603-18. doi: 10.1556/OH.2013.29593.
The last 20 years is one of the most remarkable periods in the fight against cancer, with the realization that some human papillomaviruses are causally related to cancer and with the development of the vaccine against human papillomavirus infections. This is a historical event in medicine and the prophylactic human papillomavirus vaccines have provided powerful tools for primary prevention of cervical cancer and other human papillomavirus-associated diseases. This is very important as human papillomavirus infection is probably the most common sexually transmitted infection worldwide, and over one million women develop associated cancer yearly, which is about 5% of all female cancers, and half of them die of their disease. Cancers associated with oncogenic human papillomaviruses, mostly HPV16 and 18, include cervical cancer (100%), anal cancer (95%), vulvar cancer (40%), vaginal cancer (60%), penile cancer (40%), and oro-pharingeal cancers (65%). In addition, pre-cancers such as genital warts and the rare recurrent respiratory papillomatosis are also preventable by vaccination. Currently, the human papillomavirus vaccines have the potential to significantly reduce the burden of human papillomavirus associated conditions, including prevention of up to 70% of cervical cancers. Two prophylactic human papillomavirus vaccines are currently available worldwide: a bivalent vaccine (types 16 and 18), and a quadrivalent vaccine (types 6, 11, 16, and 18). Randomized controlled trials conducted on several continents during the last 10 years have demonstrated that these vaccines are safe without serious side effects; they are highly immunogenic and efficacious in preventing incident and persistent vaccine-type human papillomavirus infections, high grade cervical, vulvar and vaginal intraepithelial neoplasia and so on. In addition, the quadrivalent vaccine has been shown to prevent genital warts in women and men. The vaccine is most effective when given to human papillomavirus naive girls. The human papillomavirus vaccines have been incorporated into national immunization programs in 22 European countries. Routine vaccination is recommended for girls aged between 9 and 13 years and catch-up vaccination for females between 13 and 25 years of age. There is no excuse not to incorporate the vaccines into the Hungarian national immunization program. Albeit vaccination is expensive, it is cost-effective in the long run definitely. Anyway, vaccination is a matter of the specialty and the national health program, but not of business. We all are obliged to prevent human suffering.
过去20年是抗癌斗争中最显著的时期之一，人们认识到某些人乳头瘤病毒与癌症存在因果关系，并且研发出了针对人乳头瘤病毒感染的疫苗。这是医学上的一个历史性事件，预防性人乳头瘤病毒疫苗为宫颈癌及其他人乳头瘤病毒相关疾病的一级预防提供了有力工具。这非常重要，因为人乳头瘤病毒感染可能是全球最常见的性传播感染，每年有超过100万女性患上相关癌症，约占所有女性癌症的5%，其中一半死于该病。与致癌性人乳头瘤病毒相关的癌症，主要是HPV16和18型，包括宫颈癌（100%）、肛门癌（95%）、外阴癌（40%）、阴道癌（60%）、阴茎癌（40%）和口咽癌（65%）。此外，生殖器疣等癌前病变以及罕见的复发性呼吸道乳头瘤病也可通过接种疫苗预防。目前，人乳头瘤病毒疫苗有潜力显著减轻人乳头瘤病毒相关疾病的负担，包括预防高达70%的宫颈癌。目前全球有两种预防性人乳头瘤病毒疫苗：二价疫苗（16和18型）和四价疫苗（6、11、16和18型）。过去10年在几大洲进行的随机对照试验表明，这些疫苗安全，无严重副作用；它们具有高度免疫原性，在预防新发和持续性疫苗型人乳头瘤病毒感染、高级别宫颈、外阴和阴道上皮内瘤变等方面有效。此外，四价疫苗已被证明可预防女性和男性的生殖器疣。该疫苗在接种于人乳头瘤病毒阴性的女孩时最有效。人乳头瘤病毒疫苗已被纳入22个欧洲国家的国家免疫规划。建议9至13岁的女孩进行常规接种，13至25岁的女性进行补种。没有理由不将这些疫苗纳入匈牙利国家免疫规划。尽管接种疫苗费用昂贵，但从长远来看肯定具有成本效益。无论如何，接种疫苗是专业领域和国家卫生项目的事情，而不是商业问题。我们都有义务预防人类的痛苦。
