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子宮頸がん

Paul A Cohen1, Anjua Jhingran2, Ana Oaknin3

  • 1Department of Gynaecological Oncology, Bendat Family Comprehensive Cancer Centre, St John of God Subiaco Hospital, Subiaco, Western Australia, WA, Australia; Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, WA, Australia.

Lancet (London, England)
|January 15, 2019
PubMed
まとめ

子宮頸がんはヒトパピローマウイルス (HPV) により引き起こされる 予防可能な病気で 毎年50万人以上の女性が罹患しています 検診,予防接種,治療における進歩は,特に高所得国において,改善された結果をもたらしています.

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科学分野:

  • 腫瘍学
  • 婦人科腫瘍学
  • 公衆衛生

背景:

  • 子宮頸がんは毎年50万人以上の女性に影響を及ぼし 予防プログラムが欠けている貧しい地域での症例が多く見られます
  • 高リスクヒトパピローマウイルス (HPV) のサブタイプは,主に予防可能な悪性腫瘍である 子宮頸がんの主な原因です.
  • 高所得国では組織的なスクリーニングプログラムにより 子宮頸がんの発生率と死亡率が著しく減少していることが観察されています.

研究 の 目的:

  • 原因,予防戦略,治療方法など,現在の子宮頸がんの状況の概要を提示する.
  • 高所得国と低所得国,中所得国間の 子宮頸がんの発症の格差を強調する.
  • 子宮頸がんの治療における最近の進歩と新たな治療方法について議論する.

主な方法:

  • 世界的な子宮頸がんの発生率と死亡率に関する疫学データのレビュー
  • HPVワクチン接種とスクリーニングプログラムが病気の負担に及ぼす影響の分析
  • 手術,放射線治療,全身治療を含む現在の治療戦略の要約
  • 免疫療法や標的薬などの新しい治療方法の探求

主要な成果:

  • 子宮頸がんは主に予防可能で HPVワクチン接種とスクリーニングが重要な介入です
  • 組織化された検診プログラムにより 高所得国における 子宮頸がんの発生率は劇的に減少しています
  • 治療方法は病気の段階によって異なりますが,初期段階の病気には生育を節約する選択肢があります.
  • 放射線治療の進歩とベバシズマブの追加は,進行したおよび再発した疾患のアウトカムを改善しました.
  • 新興の免疫療法が 転移性または再発性 子宮頸がんの管理に有望であることを示しています

結論:

  • 子宮頸がんは,特に資源の限られた地域では,世界的な健康上の大きな課題です.
  • HPVワクチン接種とスクリーニングによる効果的な予防は,病気の負担を減らすために不可欠です.
  • 手術,放射線治療,全身治療を含む多様式治療戦略は 子宮頸がんの管理に不可欠です.
  • 免疫療法のような新しい治療法に関する 研究が進んでおり 病気が進行した段階で 予後が改善される可能性が期待されています