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首页> 外文期刊>European Journal of Cancer Supplements >Prevalence and primary prevention of human papillomavirus infection in Tomsk city and Tomsk region
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Prevalence and primary prevention of human papillomavirus infection in Tomsk city and Tomsk region

机译：托木斯克市和托木斯克地区人乳头瘤病毒感染的流行和初级预防

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Cervical cancer is one of the most common female malignancies with incidence of 19.7 per 100,000 population in Russia in 2011 (Davydov, Aksel et al., 2011). Over 6000 women in Russia die of cervical cancer annually. The cervical cancer incidence shows a tendency towards increasing rates among young women (Chissov, 2009). Tomsk region has been found to be the territory of increased cancer risk for cervical cancer. The age-standardized incidence rate is 1.87 times higher in Tomsk region than in Russia, being 20.40/0000 (Pisareva, Odintsova et al., 2012). The highest incidence of cervical cancer is observed in women aged 15-39years (Churuksaeva, Kolomiets, Shpileva, 2012). The causal role of human papillomavirus infections in cervical cancer has been documented beyond reasonable doubt. Prevention of exposure to high risk HPV types by vaccination may prove to be the most efficient and logistically feasible preventive intervention for cervical cancer. Epidemiological studies conducted at the Tomsk Cancer Research Institute have shown that the median age of patients with cervical intraepithelial neoplasia and cervical cancer is 39.9+/-8.5, and 89.5% of women are HPV-positive. Prevalence of high-grade squamous intraepithelial lesion (H-SIL) peaks between ages 25years and 30years. The predominant HPV type in screened women of Tomsk region as well as worldwide is HPV-16, reaching peak incidence in women aged 36-40 years (74%). In the older age group (from 51 to 60years), HPV-18 is associated with 25% of cervical cancer cases. High prevalence of HPV-31 has been found in women under the age of 45 years with an incidence peak (17%) in the age group =<20years. The geographical widespread data on HPV type-distribution are essential for estimating the impact of vaccines on cervical cancer and cervical screening programs. Immunization against HPV for young women aged between 9 and 26years, with a predominant age cohort 11-13years, was introduced in Tomsk region in 2010. The aim of the HPV immunization program is to protect females before they reach an age when the risk of HPV infection increases. A total of 627 girls were vaccinated, and 1653 doses of vaccines were injected. The three- dose schedule was given to 414 (66%) girls and 2-dose schedule to 198 (31.6%) girls. Vaccine safety assessment was carried out. Adverse effects were observed in 9.6% of cases and were mainly characterized by dizziness and pain at the injection site. Vaccination was well tolerated. When calculating socio-economic feasibility of the proposed technology , not only the economic damage caused by the high mortality of women from cervical cancer, but also the cost for treatment of precancerous cervical lesions were taken into account, as out of 25 women with undetected CINII-III, 10 will develop cervical cancer. There have been calculated the estimated damage from cervical cancer in the Tomsk region, which takes into account not only the cost of diagnosis and treatment of cervical pre-cancer, but also losses associated with temporary permanent disabilities (social benefits, including disability pension before the age of 55years). Calculations show that the total economic damage caused by the management of patients with cervical cancer, can be from 20 to 40mln. rubles per year. Thus, primary prevention of cervical cancer, taking into account the prevalence of HPV infection and economic impact of cervical cancer can be considered as an effective technology for public health that will allow preservation of not only reproductive but also employment potential of women of Tomsk region.
机译：宫颈癌是最常见的女性恶性肿瘤之一，2011年俄罗斯每100,000人口中宫颈癌的发病率为19.7（Davydov，Aksel等人，2011）。每年，俄罗斯有6000多名妇女死于宫颈癌。子宫颈癌的发病率显示出年轻女性发病率呈上升趋势（Chissov，2009）。托木斯克州被发现是宫颈癌风险增加的地区。托木斯克州的年龄标准化发病率为20.40 / 0000，是俄罗斯的1.87倍（Pisareva，Odintsova等，2012）。宫颈癌的最高发病率出现在15-39岁的女性中（Churuksaeva，Kolomiets，Shpileva，2012年）。人类乳头瘤病毒感染在宫颈癌中的因果作用已被证实，毫无疑问。通过疫苗预防暴露于高危HPV类型可能是宫颈癌最有效且在逻辑上可行的预防干预措施。托木斯克癌症研究所进行的流行病学研究表明，宫颈上皮内瘤变和宫颈癌患者的中位年龄为39.9 +/- 8.5，其中89.5％的女性为HPV阳性。高度鳞状上皮内病变（H-SIL）的患病年龄在25岁至30岁之间。在托木斯克州乃至世界范围内受筛查的女性中，HPV的主要类型为HPV-16，在36至40岁的女性中达到最高发病率（74％）。在年龄较大的人群（51至60岁）中，HPV-18与25％的宫颈癌病例相关。在45岁以下的女性中发现HPV-31的高患病率，且在<20岁年龄组中发生率最高（17％）。关于HPV类型分布的地理分布广泛的数据对于评估疫苗对宫颈癌和宫颈筛查计划的影响至关重要。 2010年在托木斯克州开始针对9至26岁之间的年轻女性（主要人群年龄为11-13岁）进行HPV免疫。HPV免疫计划的目的是在女性达到HPV风险的年龄之前保护他们感染增加。总共为627名女孩接种了疫苗，并注射了1653剂疫苗。 414名（66％）女孩接受了三剂计划，198名（31.6％）女孩接受了两剂计划。进行了疫苗安全性评估。在9.6％的病例中观察到不良反应，主要特征是注射部位出现头晕和疼痛。疫苗耐受性良好。在计算所提出技术的社会经济可行性时，不仅考虑了宫颈癌女性高死亡率所造成的经济损失，还考虑了25例未发现CINII的女性的宫颈癌前病变的治疗费用。 -III，10岁将发展为宫颈癌。已经计算出了托木斯克州宫颈癌造成的估计损失，这不仅考虑了宫颈癌的诊断和治疗费用，还考虑了与永久性永久性残疾相关的损失（社会福利，包括在手术前的残疾抚恤金）。 55岁）。计算表明，由子宫颈癌患者治疗造成的总经济损失可能在20到4000万之间。每年卢布。因此，考虑到HPV感染的流行和宫颈癌的经济影响，对宫颈癌的一级预防可以被认为是一种有效的公共卫生技术，不仅可以保留托木斯克州妇女的生殖能力，而且可以保留其就业潜力。

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