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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >The time is now to implement HPV testing for primary screening in low resource settings
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The time is now to implement HPV testing for primary screening in low resource settings

机译：现在的时间是在低资源设置中实现对主筛选的HPV测试

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Unacceptable disparities in cervical cancer between richer and poorer countries persist and serve as reminders of gross disparities in access to and quality of screening services. HPV testing is well-suited to address some of the barriers to implementing adequate screening programs in low resource settings. HPV testing has considerably better sensitivity than cytology providing the same extent of safety with fewer rounds of screening. New robust HPV testing platforms require little to no skill by laboratory workers and some can be used at the point-of-care. This allows for a round of screening to be accomplished in one or two visits, reducing costs and the inevitable attrition that occurs when women need to be recalled to obtain their results. HPV testing is ideal for incorporating into the new "screen-and-treat" approaches designed to overcome limitations of conventional, multi-visit, colposcopy-based approaches to screening. Visual inspection with acetic acid (VIA) is the screening test that has been used most widely in screen-and-treat programs to date but the performance characteristics of this test are poor. HPV-based screen-and-treat is more effective in reducing disease in the population and reduces over-treatment intrinsic to this approach. HPV testing can be adapted or combined with other molecular tests to improve treatment algorithms. Infrastructure established to support VIA-based screen-and-treat can effectively incorporate HPV testing. We are poised at a critical juncture in public health history to implement HPV testing as part of primary screening and thereby improve women's health in low resource settings. (C) 2016 Elsevier Inc. All rights reserved.
机译：富勒斯和较贫穷国家之间的宫颈癌的不可接受的差异持续存在，并作为获取和筛选服务质量的严重差异提醒。 HPV测试非常适合解决在低资源设置中实施足够的筛选程序的一些障碍。 HPV检测比细胞学的敏感性相当更好地提供相同的安全程度，较少的筛选。新的强大的HPV测试平台需要实验室工人没有技能，其中一些可以在护理点使用。这允许在一次或两次访问中实现一轮筛选，降低成本和不可避免的磨损，当需要召回女性以获得其结果时发生。 HPV测试是纳入新的“屏幕和治疗”方法，该方法旨在克服常规，多次访问，基于阴道镜检查的筛选方法的限制。用醋酸（VIA）的目视检查是筛查测试，其在筛选和治疗方案中最广泛使用，但该测试的性能特征差。基于HPV的筛选和治疗在减少群体中的疾病并减少过治疗的内在这种方法更有效。 HPV测试可以调整或与其他分子测试组合以改善治疗算法。建立基于基于媒体和治疗的基础设施可以有效地纳入HPV测试。我们在公共卫生历史中的一个关键时刻进行了处理，以实现HPV测试作为初级筛查的一部分，从而改善妇女在低资源环境中的健康状况。 （c）2016年Elsevier Inc.保留所有权利。

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