在低资源环境中预防宫癌的查和治疗方法:一个随机对照试验
Lynette Denny1, Louise Kuhn, Michelle De Souza
1Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa.
JAMA
|November 3, 2005
概括
两种查和治疗方法用于预防宫癌,使用人类乳头瘤病毒 (HPV) DNA测试和用酸 (VIA) 进行视觉检查,与南非推迟评估相比,显著减少了高等级的前体病变.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 妇科 妇科医生 妇科
背景情况:
- 低资源环境的宫癌预防策略往往缺乏有效性数据.
- 非细胞学基础的查和治疗方法为传统查提供了替代方案.
研究的目的:
- 评估两个资源适当的宫癌预防策略的安全性和有效性.
- 将人类乳头瘤病毒 (HPV) DNA测试和视觉检查与延迟评估的乙酸 (VIA) 进行比较.
主要方法:
- 一项随机临床试验,涉及南非35-65岁的6555名女性.
- 参与者使用HPV DNA测试和VIA进行了查.
- 根据阳性测试结果或延迟评估,妇女被随机分配到冷疗法.
主要成果:
- 与对照人群相比,HPV DNA和VIA查和治疗方法在6个月和12个月内显著降低了高度宫内皮瘤 (CIN 2+) 的患病率.
- 在6个月后,CIN 2+的患病率为0.80% (HPV) 和2.23% (VIA) 与3.55% (对照) 相比.
- 低温疗法是安全的,尽管常见的轻微副作用如排泄和出血,但很少出现重大并发症.
结论:
- 使用HPV DNA测试或VIA的查和治疗方法在预防宫癌方面是安全有效的.
- 这些方法比延迟评估更有效地减少高度子宫癌前体病变.
- 该研究支持在资源有限的环境中实施这些战略.
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