Community Medicine, AIMS, Kochi, Amrita Vishwa Vidyapeetham, Kerala, India.
Int J Womens Health. 2015 Apr 16;7:405-14. doi: 10.2147/IJWH.S50001. eCollection 2015.
Cervical cancer is on the declining trend in India according to the population-based registries; yet it continues to be a major public health problem for women in India. Multifactorial causation, potential for prevention, and the sheer threat it poses make cervical cancer an important disease for in-depth studies, as has been attempted by this paper. This paper attempts to review the available knowledge regarding the epidemiology and pattern of cervical cancer; types of HPV (human papilloma virus) prevalent among cervical cancer patients and among women in general, high-risk groups such as commercial sex workers, and HIV (human immunodeficiency virus)-positive women; and the role of the national program on cancer in control efforts. The peak age of incidence of cervical cancer is 55-59 years, and a considerable proportion of women report in the late stages of disease. Specific types of oncogenic HPV-16, 18 have been identified in patients with cervical cancer. Other epidemiological risk factors are early age at marriage, multiple sexual partners, multiple pregnancies, poor genital hygiene, malnutrition, use of oral contraceptives, and lack of awareness. A multipronged approach is necessary which can target areas of high prevalence identified by registries with a combination of behavior change communication exercises and routine early screening with VIA. Sensitizing the people of the area, including menfolk, is necessary to increase uptake levels. Vaccination against types 16 and 18 can also be undertaken after taking into confidence all stakeholders, including the parents of adolescent girls. Preventing and treating cervical cancer and reducing the burden are possible by targeting resources to the areas with high prevalence.
根据人口登记处的数据,印度的宫颈癌发病率呈下降趋势;但它仍然是印度妇女的一个主要公共卫生问题。多因素病因、潜在的预防措施以及它所构成的巨大威胁,使得宫颈癌成为深入研究的重要疾病,本文正是试图对此进行研究。本文试图回顾有关宫颈癌的流行病学和模式的现有知识;宫颈癌患者和一般妇女中常见的 HPV(人乳头瘤病毒)类型,商业性工作者等高危人群,以及 HIV(人类免疫缺陷病毒)阳性妇女;以及国家癌症计划在控制工作中的作用。宫颈癌的发病高峰年龄为 55-59 岁,相当一部分妇女报告疾病处于晚期。在宫颈癌患者中已确定了特定类型的致癌 HPV-16、18。其他流行病学危险因素包括早婚、多个性伴侣、多次怀孕、不良的生殖器卫生、营养不良、口服避孕药的使用以及缺乏意识。需要采取多管齐下的方法,可以通过结合行为改变交流活动和常规的 VIA 早期筛查,针对登记处确定的高流行地区进行靶向治疗。有必要使该地区的人们,包括男性,提高认识,以提高参与度。在获得所有利益相关者的认可后,包括少女的父母,也可以针对 16 型和 18 型进行疫苗接种。通过将资源集中在高流行地区,可以预防和治疗宫颈癌并减轻其负担。