Prospects for primary prevention of cervical cancer in developing countries

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1. Verfasser: Gary Clifford
Format: Artículo científico
Sprache:en
Veröffentlicht: Instituto Nacional de Salud Pública 2003
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author Gary Clifford
author_facet Gary Clifford
contents Prospects for primary prevention of cervical cancer in developing countries Gary Clifford Martyn Plummer Silvia Franceschi Salud projection vaccination cervix neoplasms randomized controlled trials The HPV types that cause cervical cancer are sexually transmitted,but there is little evidence that infection can be avoidedby behavioural changes, such as condom use. In contrast,prophylactic vaccines against HPV infection are likely to havehigh efficacy. In principle, the effectiveness of HPV vaccinationas a strategy for cervical cancer control can be measuredeither by monitoring secular trends in cervical cancer incidenceor by conducting randomized trials. The former approachis unlikely to provide convincing evidence of effectiveness,since cervical cancer rates are subject to strong seculartrends that are independent of intervention measures. Afew phase III trials of HPV prophylactic vaccines are nowbeing started. Such trials are very expensive studies involvingfrequent and complicated investigations. It is important,however, to start as soon as possible simpler trials designedto demonstrate the effectiveness of HPV vaccine in fieldconditions, i.e. in developing or intermediate countries whichsuffer the major burden of mortality from cervical cancer.Such trials may capture a difference in the most severe, andrarest, preinvasive cervical lesions (i.e., the real target ofany HPV vaccine) over a prolonged follow-up (20 years atleast). The design of such studies is briefly considered fortwo areas: Southern India and South Korea. This paper isavailable at: http://www.insp.mx/salud/index.html 2003 artículo científico 0036-3634 https://www.redalyc.org/articulo.oa?id=10609717 en http://www.redalyc.org/revista.oa?id=106 Salud Pública de México application/pdf Instituto Nacional de Salud Pública Salud Pública de México (México) Num.3 Vol.45
format Artículo científico
id redalyc_10609717
institution Redalyc
language en
publishDate 2003
publisher Instituto Nacional de Salud Pública
spellingShingle Prospects for primary prevention of cervical cancer in developing countries
Gary Clifford
Salud
projection
vaccination
cervix neoplasms
randomized controlled trials
Prospects for primary prevention of cervical cancer in developing countries Gary Clifford Martyn Plummer Silvia Franceschi Salud projection vaccination cervix neoplasms randomized controlled trials The HPV types that cause cervical cancer are sexually transmitted,but there is little evidence that infection can be avoidedby behavioural changes, such as condom use. In contrast,prophylactic vaccines against HPV infection are likely to havehigh efficacy. In principle, the effectiveness of HPV vaccinationas a strategy for cervical cancer control can be measuredeither by monitoring secular trends in cervical cancer incidenceor by conducting randomized trials. The former approachis unlikely to provide convincing evidence of effectiveness,since cervical cancer rates are subject to strong seculartrends that are independent of intervention measures. Afew phase III trials of HPV prophylactic vaccines are nowbeing started. Such trials are very expensive studies involvingfrequent and complicated investigations. It is important,however, to start as soon as possible simpler trials designedto demonstrate the effectiveness of HPV vaccine in fieldconditions, i.e. in developing or intermediate countries whichsuffer the major burden of mortality from cervical cancer.Such trials may capture a difference in the most severe, andrarest, preinvasive cervical lesions (i.e., the real target ofany HPV vaccine) over a prolonged follow-up (20 years atleast). The design of such studies is briefly considered fortwo areas: Southern India and South Korea. This paper isavailable at: http://www.insp.mx/salud/index.html 2003 artículo científico 0036-3634 https://www.redalyc.org/articulo.oa?id=10609717 en http://www.redalyc.org/revista.oa?id=106 Salud Pública de México application/pdf Instituto Nacional de Salud Pública Salud Pública de México (México) Num.3 Vol.45
title Prospects for primary prevention of cervical cancer in developing countries
topic Salud
projection
vaccination
cervix neoplasms
randomized controlled trials
url https://www.redalyc.org/articulo.oa?id=10609717