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尼泊尔的宫颈癌:现行筛查策略和挑战。

Cervical cancer in Nepal: Current screening strategies and challenges.

机构信息

Department of Pathology and Laboratory Medicine, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, United States.

Department of Pathology, Birat Medical College Teaching Hospital, Tankisinuwari, Nepal.

出版信息

Front Public Health. 2022 Nov 17;10:980899. doi: 10.3389/fpubh.2022.980899. eCollection 2022.

Abstract

Nepal has a high burden of cervical cancer primarily due to a limited screening program. Most present with advanced cervical disease. Despite no national cervical cancer control program, Nepal's Ministry of Health and Population has taken many initiatives with various international collaborations in screening, vaccination, and treating pre-invasive and invasive cancer. However, the existing prevention and treatment modalities are dismally inadequate to meet the targets of WHO's cervical cancer eliminative initiative by 2030. We provide an overview of the Ministry of Health and Population, Nepal's efforts to tackle the growing cervical cancer burden in the country. We discuss the challenges and potential solutions that could be practical and augment screening uptakes, such as single-dose vaccination and HPV DNA tests. The screen-and-treat approach on the same day could potentially address treatment delays and follow-up loss after testing positive. Our narrative summary highlights existing and innovative strategies, unmet needs, and collaborations required to achieve elimination across implementation contexts.

摘要

尼泊尔宫颈癌负担沉重,主要原因是筛查计划有限。大多数患者的宫颈癌已处于晚期。尽管没有国家宫颈癌控制计划,但尼泊尔卫生和人口部在筛查、疫苗接种以及治疗癌前病变和浸润性癌症方面,与多个国际合作方采取了多项举措。然而,现有的预防和治疗措施远远不能满足世界卫生组织 2030 年消除宫颈癌倡议的目标。本文概述了尼泊尔卫生和人口部为应对该国日益增长的宫颈癌负担所做的努力。我们讨论了可能实用且能增加筛查参与度的挑战和潜在解决方案,如单剂量疫苗接种和 HPV DNA 检测。同一天的筛查和治疗方法有可能解决检测阳性后的治疗延迟和随访丢失问题。我们的叙述性总结突出了现有和创新的策略、未满足的需求以及在实施背景下实现消除所需的合作。

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