Prevention of human papillomavirus (HPV) infection and cervical cancer in China: How does HPV vaccination bring about benefits to Chinese women?
Prevention of human papillomavirus (HPV) infection and cervical cancer in China: How does HPV vaccination bring about benefits to Chinese women?
复制标题
中国预防人乳头瘤病毒（HPV）感染和宫颈癌：HPV疫苗接种如何为中国女性带来益处？
DOI：
10.5582/bst.2013.v7.4.159
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发表时间：
2013-01-01
影响因子：
5.5
通讯作者：
Tobe, Ruoyan Gai
中科院分区：
文献类型：
--
作者：
Liu, Xiaoyan;Feng, Aihua;Tobe, Ruoyan Gai
宫颈癌是世界上妇女癌症死亡的第二大原因，85%以上的宫颈癌病例发生在发展中国家的妇女身上。人乳头瘤病毒(HPV)感染是宫颈癌的主要原因。自2006年以来，已在全球100多个国家开发并批准了两种针对HPV高危毒株的预防性疫苗。然而，在中国，人乳头瘤病毒疫苗仍在临床试验中，等待政府批准。本文通过回顾发达国家和发展中国家实施人乳头状瘤病毒疫苗接种项目的经验，对中国引入人乳头状瘤病毒疫苗的可行性和合理性进行了探讨。疫苗接种计划在高收入和中低收入国家的宫颈癌预防和控制方面显示出显著的成本效益和巨大的健康和经济影响。另一方面，从发达国家和发展中国家的经验教训来看，仅靠二级预防不能充分发挥降低发病率和疾病负担的作用，疫苗接种计划也不能。中国的流行病学特征表明，迫切需要引入疫苗，致癌HPV型的地理多样化流行以及社会经济地位也突显了通过筛查和疫苗接种相结合的区域驱动方法预防和控制宫颈癌的重要性。
Cervical cancer is the second leading cause of cancer deaths among women in the world and more than 85% of cervical cancer cases occur in women living in developing countries. Human papillomavirus (HPV) infection is the major cause of cervical cancer. Since 2006, two prophylactic vaccines against the high-risk strains of HPV have been developed and approved in more than 100 countries around the world. However, in China, HPV vaccines are still under clinical trials for government approval. In this paper feasibility and justification of HPV vaccine introduction into China is examined by reviewing experiences in both developed and developing countries where the vaccination program has been implemented. The vaccination program has showed significant cost-effectiveness and great health and economic impacts on cervical cancer prevention and control in both high-income and middle-and low-income countries. On the other hand, based on the lessons from both developed and developing countries, secondary prevention alone cannot fully play a role to reduce the incidence and the disease burden, and neither does the vaccination program. The epidemiological characteristics in China suggest an urgent need to introduce the vaccines and the geographically diversified prevalence of oncogenic HPV types as well as socioeconomic status also highlight the importance of region-driven approaches for cervical cancer prevention and control by integration of a screening and vaccination program.