Larsen P M, Vetner M, Hansen K, Fey S J
Institute of Medical Microbiology, Aarhus University, Denmark.
Cancer Lett. 1988 Aug 15;41(2):123-37. doi: 10.1016/0304-3835(88)90109-7.
The identification of the close association of certain types of human papillomavirus with the development of cervical cancer should lead to an extensive revision of appropriate health policies. Having taken into account the drawbacks inherent in the existing data (stemming from the use of varying nomenclature, diagnostic methods and reliability, registration and screening practices) it is possible to conclude that the incidence of HPV infections, all premalignant and malignant stages of cervical cancer are, or will soon be, increasing in several countries. This rate of increase is fastest for the younger age groups and is despite the introduction of various forms of screening. These trends therefore indicate an urgent need to adopt policies to avert an unnecessary increase in fatalities due to cervical cancer. It is therefore recommended to: (1) establish a routine diagnostic method which can identify either the type of HPV present or the lesions which are progressing; (2) determine the incidence of HPV infections in the general population; (3) disseminate to medical personnel, teachers, and other members of society existing knowledge concerning the dangers associated with this virus and relevant to preventing its further spread; (4) introduce an effective population screening campaign for all sexually active women, preferably involving a yearly examination at a colposcopy clinic; (5) intensify basic and applied HPV research, especially that which could lead to a deeper understanding of viral transmission and infection, identification of cofactors which promote cervical lesion progression, or to the production of a vaccine.
某些类型的人乳头瘤病毒与宫颈癌发生之间紧密关联的确定，应促使对适当的卫生政策进行广泛修订。考虑到现有数据存在的缺陷（源于使用不同的命名法、诊断方法及其可靠性、登记和筛查做法），可以得出结论，在一些国家，人乳头瘤病毒感染率以及宫颈癌所有癌前和恶性阶段的发生率正在上升，或很快将上升。尽管已采用各种形式的筛查，但这种上升速度在较年轻年龄组中最快。因此，这些趋势表明迫切需要采取政策，以避免宫颈癌导致的死亡人数不必要地增加。因此建议：（1）建立一种常规诊断方法，能够识别存在的人乳头瘤病毒类型或正在进展的病变；（2）确定普通人群中人乳头瘤病毒感染率；（3）向医务人员、教师和社会其他成员传播有关该病毒相关危险以及预防其进一步传播的现有知识；（4）针对所有性活跃女性开展有效的人群筛查活动，最好每年在阴道镜诊所进行检查；（5）加强基础和应用人乳头瘤病毒研究，特别是那些能够更深入了解病毒传播和感染、识别促进宫颈病变进展的辅助因素或生产疫苗的研究。
