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首頁> 美國衛(wèi)生研究院文獻(xiàn)>British Journal of Cancer >Present evidence on the value of HPV testing for cervical cancer screening: a model-based exploration of the (cost-)effectiveness.
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Present evidence on the value of HPV testing for cervical cancer screening: a model-based exploration of the (cost-)effectiveness.

機譯：目前有關(guān)HPV檢測對宮頸癌篩查的價值的證據(jù)：（成本）效果的基于模型的探索。

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Human papillomavirus (HPV) is the main risk factor for invasive cervical cancer. High risk ratios are found in cross-sectional data on HPV prevalence. The question raised is whether this present evidence is sufficient for making firm recommendations on HPV screening. A validated cervical cancer screening model was extended by adding HPV infection as a possible precursor of cervical intraepithelial neoplasia (CIN). Two widely different model quantifications were constructed so that both were compatible with the observed HPV risk ratios. One model assumed a much longer duration of HPV infection before progressing to CIN and a higher sensitivity of the HPV test than the other. In one version of the model, the calculated mortality reduction from HPV screening was higher and the (cost-)effectiveness was much better than for Pap smear screening. In the other version, outcomes were the opposite, although the cost-effectiveness of the combined HPV + cytology test was close to that of Pap smear screening. Although small follow-up studies and studies with limited strength of design suggest that HPV testing may well improve cervical cancer screening, only large longitudinal screening studies on the association between HPV infection and the development of neoplasias can give outcomes that would enable a firm conclusion to be made on the (cost-)effectiveness of HPV screening. Prospective studies should address women aged 30-60 years.
機譯：人乳頭瘤病毒（HPV）是浸潤性宮頸癌的主要危險因素。在有關(guān)HPV患病率的橫斷面數(shù)據(jù)中發(fā)現(xiàn)高風(fēng)險比率。提出的問題是，目前的證據(jù)是否足以對HPV篩查提出堅定的建議。通過添加HPV感染作為宮頸上皮內(nèi)瘤變（CIN）的可能前體，擴展了經(jīng)過驗證的宮頸癌篩查模型。構(gòu)建了兩種截然不同的模型定量，以使二者均與觀察到的HPV風(fēng)險比兼容。一種模型認(rèn)為，在發(fā)展為CIN之前，HPV感染的持續(xù)時間要長得多，而HPV檢測的靈敏度要高于另一種模型。在該模型的一個版本中，與通過子宮頸抹片檢查相比，通過HPV篩查計算出的死亡率降低要高得多，并且（成本）效果要好得多。在另一個版本中，結(jié)果是相反的，盡管組合的HPV +細(xì)胞學(xué)檢查的成本效益接近巴氏涂片篩查的成本效益。盡管較小的隨訪研究和設(shè)計強度有限的研究表明，HPV檢測可以很好地改善子宮頸癌的篩查，但是只有有關(guān)HPV感染與瘤形成發(fā)展之間關(guān)系的大型縱向篩查研究才能得出可以得出肯定結(jié)論的結(jié)果。 HPV篩查的（成本）有效性。前瞻性研究應(yīng)針對30-60歲的女性。

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