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从潜力到实践:加速获得人乳头瘤病毒检测及筛查与治疗项目如何助力消除宫颈癌

From potential to practice: how accelerating access to HPV tests and screen and treat programmes can help eliminate cervical cancer.

作者信息

Cherniak William, Tyler Nikki, Arora Kriti, Lapidos-Salaiz Ilana, Sczudlo Emma, Lin Amy, Barnhart Matthew, Flanigan John, Silkensen Shannon

机构信息

Bridge to Health Medical and Dental, Toronto, Ontario, Canada.

Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.

出版信息

Fam Med Community Health. 2019 Oct 31;7(4):e000182. doi: 10.1136/fmch-2019-000182. eCollection 2019.

Abstract

Human papillomavirus (HPV) vaccination campaigns to prevent cervical cancer are being considered and implemented in countries around the world. While vaccination will protect future generations, it will not help the millions of women currently infected, leading to an estimated 311 000 deaths per year globally. This paper examines a selection of strategies that when applied to both existing and new technologies, could accelerate access to HPV testing. Authors from the US Agency for International Development, the National Institutes of Health, and the Bridge to Health Medical and Dental, a non-governmental organisation, joined forces to propose a scalable and country-directed solution for preventing cervical cancer using an end-to-end approach. Collectively, the authors offer seven evidence-based strategies, that when used alone or in combination have the ability to reduce HPV-caused cervical cancer deaths and disability. These strategies include (1) consistent HPV test intervals to decrease HPV DNA test costs; (2) exploring market shaping opportunities; (3) employing iterative user research methodologies like human-centred design; (4) target product profiles for new HPV tests; (5) encouraging innovation around cervical cancer screen and treat programmes; (6) developing national cancer control plans; and (7) integrating cervical cancer screen and treat services into existing infrastructure. By using the strategies outlined here, in combination with HPV vaccination campaigns, national governments will be able to scale and expand cervical cancer screening programmes and provide evidence-based treatment programmes for HPV-infected women.

摘要

全球各国都在考虑并实施预防宫颈癌的人乳头瘤病毒(HPV)疫苗接种活动。虽然疫苗接种将保护后代,但对于目前已感染的数百万女性却无济于事,这导致全球每年估计有31.1万人死亡。本文探讨了一系列策略,这些策略若应用于现有技术和新技术,可加速HPV检测的普及。美国国际开发署、美国国立卫生研究院以及非政府组织“健康桥梁医疗与牙科”的作者们联合起来,提出了一种可扩展且以国家为导向的解决方案,采用端到端方法预防宫颈癌。作者们共同提供了七种基于证据的策略,单独或组合使用这些策略都有能力减少HPV引发的宫颈癌死亡和残疾。这些策略包括:(1)保持一致的HPV检测间隔以降低HPV DNA检测成本;(2)探索市场塑造机会;(3)采用以用户为中心设计等迭代式用户研究方法;(4)确定新HPV检测的目标产品概况;(5)鼓励围绕宫颈癌筛查和治疗项目进行创新;(6)制定国家癌症控制计划;(7)将宫颈癌筛查和治疗服务整合到现有基础设施中。通过运用此处概述的策略,再结合HPV疫苗接种活动,各国政府将能够扩大和拓展宫颈癌筛查项目,并为感染HPV的女性提供基于证据的治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f40b/6910768/4eade2d4ff1f/fmch-2019-000182f01.jpg

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