The viral etiology of cervical cancer
The viral etiology of cervical cancer
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DOI：
10.1016/s0168-1702(02)00187-9
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发表时间：
2002-11-01
期刊：
影响因子：
5
通讯作者：
Muñoz, N
中科院分区：
文献类型：
--
作者：
Bosch, FX;Muñoz, N
分子技术支持的流行病学研究已经提供了足够的证据，证明某些人乳头瘤病毒（HPV）感染在宫颈癌发展中的因果作用。这种关联已经在所有提出的因果关系标准下进行了评估，并得到了科学界和主要审查机构的认可。人类乳头瘤病毒被认为是人类癌症的第一个确定的必要原因。实际上，必要原因的概念意味着，如果没有hpv -脱氧核糖核酸（DNA）的持续存在，宫颈癌不会也不会发展。这一重要进展在预防方面具有两个实际意义。首先，如果HPV检测被明智地纳入解决模糊细胞学读数的部分，筛查程序可以得到加强。在一些人群中，HPV筛查作为主要检测可能被证明是一种选择策略。其次，就像乙型肝炎模型一样，目前正在大力开发和测试疫苗，以预防相关的HPV感染，可能还有宫颈癌。在这一发展阶段，要求监管机构评估科学证据，并权衡其对成本、公共卫生投资和政策的影响。这是一种主观评价，可以通过对最相关的研究和发现的仔细描述来指导。(C) 2002 Elsevier Science B.V.版权所有
Epidemiological studies supported by molecular technology have provided sufficient evidence on the causal role of some Human Papillomavirus (HPV) infections in the development of cervical cancer. This association has been evaluated under all proposed sets of causality criteria and endorsed by the scientific community and major review institutes. HPV has been proposed as the first-ever identified, necessary cause of a human cancer. In practical terms, the concept of a necessary cause implies that cervical cancer does not and will not develop in the absence of the persistent presence of HPV-deoxyribonucleic acid (DNA). This important advancement has two practical implications in prevention. Firstly, screening programs can be enhanced if HPV testing is judiciously incorporated into solving the fraction of ambiguous cytology readings. In some populations HPV screening as a primary test may prove to be the strategy of choice. Secondly, like in the hepatitis B disease model, intense efforts are currently being put into the development and testing of vaccines that may prevent the relevant HPV infections, and presumably, cervical cancer. At this stage of development, regulatory agencies are requested to evaluate the scientific evidence and weigh its implications in relation to costs, public health investments and policy. This is a subjective evaluation that could be guided by a careful description of the most relevant studies and findings. (C) 2002 Elsevier Science B.V. All rights reserved.