Haruyama Rei, Obara Hiromi, Fujita Noriko
Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
Glob Health Med. 2021 Feb 28;3(1):44-47. doi: 10.35772/ghm.2020.01070.
Following the global call to action by the World Health Organization (WHO), the world is currently moving to eliminate cervical cancer as a public health problem. To eliminate the cancer within this century, which is defined as an age-adjusted cervical cancer incidence rate (ASIR) below 4 per 100,000 women, WHO recommends all countries to achieve "90-70-90" targets for human papilloma virus (HPV) vaccination, cervical cancer screening, and treatment of precancer and cancer by 2030. In Japan, ASIR has been rising since the late 1990s to 11.1 per 100,000 women, and this rise is particularly prominent in women of reproductive age. HPV vaccination coverage is as low as 0.3%, largely due to the Governments ongoing suspension of proactive recommendations for the vaccine. Given the absence of centralized, population-based cervical cancer screening program and a nationwide surveillance system for systematic monitoring, the exact screening participation rate and treatment rate are difficult to estimate. A national survey suggested that only around 40% of women between the ages of 20 and 69 years underwent cervical cancer screening within the last two years. National policies and systems for HPV vaccination and screening should be updated in a more efficient way as new evidence and innovations become available. In the wake of powerful global momentum, actions must be taken now to further enhance cervical cancer control and ensure that Japanese girls and women are no longer left behind.
在世界卫生组织(WHO)发出全球行动呼吁之后,全球目前正朝着消除宫颈癌这一公共卫生问题迈进。为在本世纪内消除宫颈癌(定义为年龄标准化宫颈癌发病率(ASIR)低于每10万名女性4例),WHO建议所有国家到2030年实现人乳头瘤病毒(HPV)疫苗接种、宫颈癌筛查以及癌前病变和癌症治疗的“90-70-90”目标。在日本,自20世纪90年代末以来,ASIR已升至每10万名女性11.1例,且这种上升在育龄女性中尤为显著。HPV疫苗接种覆盖率低至0.3%,这在很大程度上是由于政府持续暂停对该疫苗的积极推荐。鉴于缺乏集中的、基于人群的宫颈癌筛查项目以及用于系统监测的全国性监测系统,确切的筛查参与率和治疗率难以估计。一项全国性调查表明,在过去两年中,年龄在20至69岁之间的女性中只有约40%接受了宫颈癌筛查。随着新证据和创新成果的出现,HPV疫苗接种和筛查的国家政策及系统应以更有效的方式更新。在强大的全球势头推动下,现在必须采取行动进一步加强宫颈癌防控,确保日本的女孩和妇女不再落后。