Tài liệu Preventing cervical cancer: Unprecedented opportunities for improving women’s health docx

Volume 23

Number 1

June 2007

Outlook

In this issue

• Cervical cancer and

human papillomavirus

(HPV)

• Need for improved

prevention methods

• Cervical cancer

screening update

• Current and future

vaccines

• Getting vaccine to those

who need it most

Preventing

cervical cancer:

Unprecedented

opportunities for

improving women’s

health

Cervical cancer is the second most

common cancer in women worldwide

and the leading cause of cancer deaths in

women in developing countries (Box 1). It

is a disease of unfortunate inequities but

also of exciting opportunities.

The inequities

The incidence and mortality rate of

cervical cancer have declined significantly

in industrialized countries in the past 40

or so years, but in developing countries,

this disease continues to be an enormous

problem. But even in the industrialized

world, some women do not receive the

care they need. Thus, one inequity is

between richer and poorer women. With

appropriate health care, wealthy women in

poorer countries are likely to be better off

than poor women in wealthier countries.

The second inequity is based on gender:

cervical cancer is a female disease, and

in many countries women do not receive

equal information about or access to

health care.

The opportunities

A vaccine against cervical cancer is now

available. This vaccine can be comple￾mented with improved cervical screening

to achieve a substantial reduction in

cervical cancer, a disease that shatters

families and destroys the lives of women

in their prime. The costs of cervical cancer

to communities and to individual women

and their families are great, but this situ￾ation can be improved. To realize the full

potential of the human papillomavirus

(HPV) vaccine requires universal coverage

of adolescent girls before the possibility of

HPV contact. Although it will be chal￾lenging to reach these girls—many of

whom do not routinely see health care

providers—once effective systems are in

place, they can be used to provide many

additional health interventions necessary

for older children and young adolescents.

The fight against cervical cancer, a

disease that is preventable, can be regarded

as both a health issue and a human rights

and ethical issue. Current tools can

tackle this problem and help to give more

women, their families, and their commu￾nities a future without cervical cancer.

Cervical cancer and human

papillomavirus (HPV)

The disease: an unequal burden

Nearly half a million new cases of invasive

cervical cancer are diagnosed each year,

about half in women who have never been

screened. Worldwide, more than a quarter

million women die of this disease annually.

The highest incidence and mortality rates

are in sub-Saharan Africa, Latin America,

and South Asia (see Figure 1). Overall, the

mortality rates in developing countries are

about four times those in industrialized

countries; 80% to 85% of cervical cancer

deaths occur in developing countries. In

these regions, cervical cancer generally

affects women with multiple school-age

children, and their deaths have a major

negative impact on the social fabric of

their communities.1–3,5,6,9–12

Human papillomavirus (HPV)

Nearly all cases of cervical cancer are

associated with HPV, an easily transmis￾sible, highly prevalent, tissue-specific DNA