Coordinator Unit Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium.
Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Int J Cancer. 2021 Jan 15;148(2):277-284. doi: 10.1002/ijc.33189. Epub 2020 Aug 4.
The age-standardised incidence of cervical cancer in Europe varies widely by country (between 3 and 25/100000 women-years) in 2018. Human papillomavirus (HPV) vaccine coverage is low in countries with the highest incidence and screening performance is heterogeneous among European countries. A broad group of delegates of scientific professional societies and cancer organisations endorse the principles of the WHO call to eliminate cervical cancer as a public health problem, also in Europe. All European nations should, by 2030, reach at least 90% HPV vaccine coverage among girls by the age of 15 years and also boys, if cost-effective; they should introduce organised population-based HPV-based screening and achieve 70% of screening coverage in the target age group, providing also HPV testing on self-samples for nonscreened or underscreened women; and to manage 90% of screen-positive women. To guide member states, a group of scientific professional societies and cancer organisations engage to assist in the rollout of a series of concerted evidence-based actions. European health authorities are requested to mandate a group of experts to develop the third edition of European Guidelines for Quality Assurance of Cervical Cancer prevention based on integrated HPV vaccination and screening and to monitor the progress towards the elimination goal. The occurrence of the COVID-19 pandemic, having interrupted prevention activities temporarily, should not deviate stakeholders from this ambition. In the immediate postepidemic phase, health professionals should focus on high-risk women and adhere to cost-effective policies including self-sampling.
2018 年，欧洲各国宫颈癌标准化发病率差异很大（女性每 10 万人年 3-25 例）。在发病率最高的国家，人乳头瘤病毒（HPV）疫苗接种率较低，欧洲各国的筛查效果也存在差异。一组科学专业协会和癌症组织的代表支持世界卫生组织消除宫颈癌这一公共卫生问题的呼吁，这也适用于欧洲。所有欧洲国家都应在 2030 年之前，在 15 岁以下女孩中至少达到 90%的 HPV 疫苗接种率，如果具有成本效益，也应包括男孩；他们应开展有组织的基于人群的 HPV 筛查，并在目标年龄组中实现 70%的筛查覆盖率，为未筛查或筛查不足的女性提供 HPV 自我采样检测；并管理 90%的筛查阳性女性。为了指导成员国，一组科学专业协会和癌症组织参与协助推出一系列协调一致的基于证据的行动。应要求欧洲卫生当局授权一组专家根据综合 HPV 疫苗接种和筛查制定第三版欧洲宫颈癌预防质量保证指南，并监测实现消除目标的进展情况。COVID-19 大流行的发生暂时中断了预防活动，但不应使利益相关者偏离这一目标。在大流行后的初期阶段，卫生专业人员应关注高风险女性，并坚持实施具有成本效益的政策，包括自我采样。
