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Current cervical cancer prevention strategies including cervical screening and prophylactic human papillomavirus vaccination: A review

机译:当前的宫颈癌预防策略包括宫颈筛查和预防性人乳头瘤病毒疫苗接种:综述

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PURPOSE OF REVIEW: As screening methods evolve and human papillomavirus (HPV) vaccination efforts gain traction, knowledge of the current evidence on effectiveness of prevention methods is critical to support further development of programs. RECENT FINDINGS: Screening has dramatically reduced cervical cancer incidence and mortality; however, further progress could be made with implementing new screening techniques, such as HPV DNA testing. Continued focus has been given to methods such as visual inspection with acetic acid/Lugol's iodine (VIA/VILI) and self-testing, which may provide an alternative in settings and populations wherein infrastructural challenges and logistical barriers pose challenges to achieving high screening coverage. Postlicensure studies of HPV vaccine show continued effectiveness against genital warts, the first outcome possible to measure. Of note, age-at-vaccination seems to play a pivotal role in effectiveness. Studies examining safety of the HPV vaccines could not confirm any increased risk associated with vaccination. SUMMARY: Existing cervical screening techniques are effective; however, programs should consider implementing HPV DNA testing where applicable and further process developments for alternative methods may result in improved results. The HPV vaccine is safe and effective and should be given before sexual debut to achieve maximum protection.
机译:审查的目的:随着筛查方法的发展和人类乳头瘤病毒(HPV)疫苗接种工作的吸引,对预防方法有效性的最新证据的了解对于支持计划的进一步发展至关重要。最近的发现:筛查大大降低了子宫颈癌的发病率和死亡率。但是,通过实施新的筛选技术(例如HPV DNA测试)可以取得进一步的进展。继续重点关注诸如使用乙酸/卢戈尔碘进行视觉检查(VIA / VILI)和自检等方法,这些方法可能会在基础设施挑战和后勤障碍给实现高筛查覆盖率带来挑战的环境和人群中提供替代方案。 HPV疫苗的上市后研究表明,针对尖锐湿疣的持续有效性,这是第一个可以衡量的结果。值得注意的是,接种年龄似乎在有效性中起着关键作用。检验HPV疫苗安全性的研究无法确认与疫苗接种相关的任何增加的风险。总结:现有的宫颈筛查技术是有效的。但是,程序应考虑在适用的情况下实施HPV DNA测试,并且进一步开发替代方法的方法可能会导致结果改善。 HPV疫苗是安全有效的,应在性行为初次接种前给予接种,以实现最大程度的保护。

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