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消除和控制宫颈癌的公共卫生方法:综述

Public Health Approach in the Elimination and Control of Cervical Cancer: A Review.

作者信息

Jallah John Kessellie, Anjankar Ashish, Nankong Francis A

机构信息

Department of Biochemistry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Department of Science and Technology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2023 Sep 1;15(9):e44543. doi: 10.7759/cureus.44543. eCollection 2023 Sep.

Abstract

Public health experts worldwide have emphasized cervical cancer since it is a substantial global health burden primarily affecting women. This article thoroughly reviews the public health approach to eradicating and managing cervical cancer. The public health community seeks to lower the prevalence, morbidity, and mortality linked to this preventable disease by integrating primary prevention by means of vaccination against the human papillomavirus (HPV), secondary prevention using screening and early identification, and tertiary prevention through improved therapy and supportive care. In order to accomplish broad vaccination coverage and ultimately effectively prevent cervical cancer, it remains crucial to address obstacles to vaccine accessibility, reluctance, and fair distribution. Early identification and subsequent treatments depend greatly on cervical cancer screening programs. This study explores several screening methods, such as Papanicolaou (Pap) tests based on cytology and cutting-edge technologies like molecular assays and HPV detection. The detection of precancerous lesions and early-stage malignancies, permitting prompt treatment, has shown significant promise when integrating these technologies into coordinated population-based screening programs. The study also underlines the significance of addressing cervical cancer burden inequities, particularly in resource-constrained areas where access to preventative and curative care is constrained. Innovative and affordable methods for addressing marginalized groups are studied, including community-based outreach programs, mobile health technology, and local healthcare practitioners and community leaders in awareness campaigns. The research also examines improvements in cervical cancer treatment procedures, such as surgery, radiation, chemotherapy, and immunotherapy. It improves therapeutic efficacy and patient survival rates by incorporating various modalities into a multidisciplinary strategy. Highlighted palliative care and psychological support are crucial for patients who have advanced cervical carcinoma.

摘要

全球公共卫生专家一直强调宫颈癌问题,因为它是一项重大的全球卫生负担,主要影响女性。本文全面回顾了根除和管理宫颈癌的公共卫生方法。公共卫生界试图通过整合以下措施来降低与这种可预防疾病相关的患病率、发病率和死亡率:通过接种人乳头瘤病毒(HPV)疫苗进行一级预防,利用筛查和早期识别进行二级预防,以及通过改善治疗和支持性护理进行三级预防。为了实现广泛的疫苗接种覆盖率并最终有效预防宫颈癌,解决疫苗可及性、抵触情绪和公平分配方面的障碍仍然至关重要。早期识别和后续治疗在很大程度上依赖于宫颈癌筛查项目。本研究探讨了几种筛查方法,如基于细胞学的巴氏(Pap)试验以及分子检测和HPV检测等前沿技术。当将这些技术整合到基于人群的协调筛查项目中时,对癌前病变和早期恶性肿瘤的检测能够实现及时治疗,已显示出巨大的前景。该研究还强调了解决宫颈癌负担不平等问题的重要性,特别是在资源有限地区,那里获得预防和治疗护理的机会受到限制。研究了针对边缘化群体的创新且经济实惠的方法,包括基于社区的外展项目、移动健康技术,以及在提高认识运动中让当地医疗从业者和社区领袖参与。该研究还考察了宫颈癌治疗程序的改进,如手术、放疗、化疗和免疫疗法。通过将多种治疗方式纳入多学科策略,提高了治疗效果和患者生存率。强调了姑息治疗和心理支持对晚期宫颈癌患者至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3750/10544705/5ff2d3e2a910/cureus-0015-00000044543-i01.jpg

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