Do selective estrogen receptor modulators treat cervical precancer and cancer? Time to pool data from relevant trials.

摘要

Based on the nearly absolute etiologic link between carcinogenic human papillomavirus (HPV) and cervical cancer, two new approaches for the prevention of cervical cancer have emerged: (i) HPV vaccination for primary HPV prevention in younger women and (2) carcinogenic HPV detection for secondary prevention via identifying and treating cervical precancer and early cancers. Both have demonstrated high degrees of efficacy with maximum effectiveness guided by an understanding of the causal model and application of these technologies in an age appropriate manner.1 Despite the advent of these promising prevention tools, there is a real need to develop nonsurgical methods for treating cervical precancerous lesions and even early cancer for three reasons. First, current HPV vaccines are prophylactic and do not treat pre-existing HPV infections.1 Second, surgical excision of screen-detected precancerous lesions, while a highly efficacious (90-95%) treatment1 increases the risk of preterm delivery and infant morbidity and mortality.