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更新日期:2008/12/08 21:35
外電報導，德國科學家說，研究發現，截至目前子宮頸癌疫苗還沒能證明有效，建議政府不要花大筆錢給年輕女孩施打；對此，國內醫師表示，疫苗是否可以降低子宮頸癌的「發生率」的臨床證明，必須等到20~30年後才會出爐，但由於許多研究都發現，接種疫苗者，子宮頸癌「癌前病變」的患者數是下降的，將來罹患子宮頸癌的機會便會減少，因此，雖然發生率的直接證據還未出爐，但子宮頸癌疫苗，已被非常強烈的證實，可以預防子宮頸癌。(徐韻翔報導)
外電報導，德國科學家說，到目前為止，子宮頸癌疫苗還沒能證明有效，研究人員說，藥效的科學研究結果跟藥商發表的結果有相當的差別，目前只有證據顯示，疫苗在子宮頸癌初期對十五到十七歲女孩罹患有效果，他們希望德國政府不要再花錢讓年輕女孩接種子宮頸癌疫苗。
子宮頸癌疫苗到底管不管用？台大醫院婦產部主治醫師鄭文芳表示，基於醫學倫理考量，所有參與相關疫苗臨床實驗者，如果出現重度癌前病變就會中止實驗，讓患者接受治療，目前沒有直接證據可以證明疫苗可以預防子宮頸癌，直接證據必須要等到接種疫苗的年輕女性，二、三十年後，和上一代的媽媽輩相較，觀察子宮頸癌發生率是否大幅下降，屆時才能下定論，但如果現在不做大規模施打，永遠都不會有結果，而目前的臨床研究都強烈證實，接種子宮頸疫苗者，發生癌前病變機率降低，由此可研判，將來發生子宮頸癌的機會也會降低。
至於疫苗建議接種年齡，鄭文芳說，接種子宮頸癌疫苗，女性還沒有性行為前、尚未感染到人類乳突病毒前打最佳，至於每個國家幾歲施打，依國情標準不一，國內專家共識則普遍認為，雖然衛生署核准的接種年齡是9歲就可打，但基於國情評估，台灣的女性建議是在國一，也就是12~13歲左右的女孩，可以接種子宮頸癌疫苗。
子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
版主: 版主021
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blind faith
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Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
Berlin - Findings by several German scientists suggest there is insufficient proof that the vaccine against cervical cancer is effective. from Deutsche Presse-Agentur
Thirteen researchers at the Public Health Institute at the University of Bielefeld have urged the German Standing Vaccination Committee, which advises the German government on vaccination practices, to re-examine the vaccination against human papilloma virus.
The researchers found that the results of different studies contradicted many optimistic, official findings.
The researchers made the plea in a joint statement.
"I would like to read a serious publication that claims cervical cancer has been reduced in any country due to the vaccination," says Professor Martina Doeren of Berlin's Charite Hospital.
Doeren is one of the researchers who signed the statement questioning the vaccine's effectiveness and said there was a "huge discrepancy" between the results of scientific studies and hitherto-published figures.
Doeren says she wishes the claims made on behalf of the vaccine were true, but at present there is no evidence to confirm them.
The researchers have criticised the Standing Vaccination Committee's advice that girls between the ages of 12 and 17 should receive the vaccination.
"There is only evidence to show the vaccine can prevent the preliminary stages of cervical cancer in girls between 15 and 17 but not in the 12 to 14 age group," according to the statement.
But in response to the researchers' request for more exact data, manufacturers of the vaccine said the data was only available to scientists who were directly involved with their analysis.
Doeren has also criticised the cost of providing the vaccine to the public. The lack of evidence did not justify the several hundred million dollars it costs to provide the drug, she said and suggested the vaccine was part of a marketing campaign putting enormous pressure on women.
The virus that causes cervical cancer is spread during sexual intercourse. However, there is hardly any attempt to make men aware of the issue, said Doeren. dpa/tmn
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像是研究者對德國政府疫苗政策的陳情.
目前當然還沒有夠長的追蹤時間來看大規模子宮頸癌疫苗接種能不能降低 incidence.
但對於癌前病變的發生率是有降低的.
只是到底是幾歲時打比較好?? 這需要更有 evidence-base
除非當今的癌症學說是錯的, 否則應該還是會有效 (需要長期時間證明.....)
重要的是生活應該要檢點, 比較少有受HPV 感染的機會
Thirteen researchers at the Public Health Institute at the University of Bielefeld have urged the German Standing Vaccination Committee, which advises the German government on vaccination practices, to re-examine the vaccination against human papilloma virus.
The researchers found that the results of different studies contradicted many optimistic, official findings.
The researchers made the plea in a joint statement.
"I would like to read a serious publication that claims cervical cancer has been reduced in any country due to the vaccination," says Professor Martina Doeren of Berlin's Charite Hospital.
Doeren is one of the researchers who signed the statement questioning the vaccine's effectiveness and said there was a "huge discrepancy" between the results of scientific studies and hitherto-published figures.
Doeren says she wishes the claims made on behalf of the vaccine were true, but at present there is no evidence to confirm them.
The researchers have criticised the Standing Vaccination Committee's advice that girls between the ages of 12 and 17 should receive the vaccination.
"There is only evidence to show the vaccine can prevent the preliminary stages of cervical cancer in girls between 15 and 17 but not in the 12 to 14 age group," according to the statement.
But in response to the researchers' request for more exact data, manufacturers of the vaccine said the data was only available to scientists who were directly involved with their analysis.
Doeren has also criticised the cost of providing the vaccine to the public. The lack of evidence did not justify the several hundred million dollars it costs to provide the drug, she said and suggested the vaccine was part of a marketing campaign putting enormous pressure on women.
The virus that causes cervical cancer is spread during sexual intercourse. However, there is hardly any attempt to make men aware of the issue, said Doeren. dpa/tmn
------------------------------------------------
像是研究者對德國政府疫苗政策的陳情.
目前當然還沒有夠長的追蹤時間來看大規模子宮頸癌疫苗接種能不能降低 incidence.
但對於癌前病變的發生率是有降低的.
只是到底是幾歲時打比較好?? 這需要更有 evidence-base
除非當今的癌症學說是錯的, 否則應該還是會有效 (需要長期時間證明.....)
重要的是生活應該要檢點, 比較少有受HPV 感染的機會
'We are all just prisoners here of our own device'
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medfront
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Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
重要的是男人還是女人的生活應該要檢點, , 受 HPV 感染的機會才會較少?blind faith 寫: 重要的是生活應該要檢點, 比較少有受HPV 感染的機會
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chichang
- 科主任級
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pinging
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Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
在B型肝炎疫苗政策實施之時
也有一大堆反對意見
當時我們只知道能夠減少帶原率
也沒有證據說B型肝炎疫苗可以降低肝硬化、肝癌的發生率
但當時已經知道那是必然的
HPV疫苗也是這樣
我們不可能等到有證據顯示疫苗可降低子宮頸癌發生率才來實施政策
那是過度顢頇保守的作法
從子宮頸癌的流行病學
可清楚知道病毒感染以後經過好多年才會發展成癌症
而這些感染幾乎都是二、三十歲發生的
所以子宮頸癌才在中年以後大增
要打疫苗，就要在感染發生之前的青少年
可惜的是國內有婦女團體堅持反對
所以昨天國建局局長說：「由於部分婦女團體持反對意見，且有安全性爭議，此案有待凝聚社會共識，短期之內，不會列入公費疫苗範圍。」
HPV疫苗最大的問題不在於有效性，也不在於安全性
而在於昂貴的價格
每年台灣有八百多名子宮頸癌婦女死亡，有更多婦女會因為罹癌而面對病痛的創傷
我希望以後這些受害婦女能出面要求這些反對的婦女團體負責
這些婦女團體也應該知道她們做的事情可能傷害到千千萬萬名婦女同胞
也有一大堆反對意見
當時我們只知道能夠減少帶原率
也沒有證據說B型肝炎疫苗可以降低肝硬化、肝癌的發生率
但當時已經知道那是必然的
HPV疫苗也是這樣
我們不可能等到有證據顯示疫苗可降低子宮頸癌發生率才來實施政策
那是過度顢頇保守的作法
從子宮頸癌的流行病學
可清楚知道病毒感染以後經過好多年才會發展成癌症
而這些感染幾乎都是二、三十歲發生的
所以子宮頸癌才在中年以後大增
要打疫苗，就要在感染發生之前的青少年
可惜的是國內有婦女團體堅持反對
所以昨天國建局局長說：「由於部分婦女團體持反對意見，且有安全性爭議，此案有待凝聚社會共識，短期之內，不會列入公費疫苗範圍。」
HPV疫苗最大的問題不在於有效性，也不在於安全性
而在於昂貴的價格
每年台灣有八百多名子宮頸癌婦女死亡，有更多婦女會因為罹癌而面對病痛的創傷
我希望以後這些受害婦女能出面要求這些反對的婦女團體負責
這些婦女團體也應該知道她們做的事情可能傷害到千千萬萬名婦女同胞
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chichang
- 科主任級
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Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
Prescrire Int. 2007 Jun;16(89):91-4.Links
Human papillomavirus vaccine for genotypes 6, 11, 16 and 18: new drug. Cervical cancer prevention: high hopes....[No authors listed]
(1) Most cases of high-grade anogenital dysplasia and malignancy are caused by human papillomavirus (HPV) genotypes 16 and 18. Anogenital papilloma and condyloma acuminata are mainly caused by HPV6 and HPV11. (2) A recombinant vaccine covering these four genotypes is now marketed in the European Union for the prevention of condyloma, precancerous lesions, and cancers of the female lower genital tract. (3) A three-dose vaccination schedule (0, 2 and 6 months) elicits an immune response in almost all women, but the minimum antibody titre required for clinical protection is not known. Immune protection lasts at least 5 years, but no one knows what happens after that time. (4) Three double-blind randomised placebo-controlled trials involving a total of about 18 000 women aged 16 to 23 had sufficiently similar designs to pool results for analysis. Nearly all (around 98%) of women not yet infected with papillomavirus of a genotype covered by the vaccine were protected from dysplasia caused by one of these genotypes. The vaccine did not affect dysplasia caused by other genotypes, nor was it effective in women who were already infected. In total, among women not yet infected with a papillomavirus genotype covered by the vaccine, the vaccine prevented about 38% of high-grade dysplasias of all types (0.5 versus 0.8 cases per 100 woman-years). (5) The vaccine also markedly reduced the incidence of genital warts and high-grade vulvar and vaginal dysplasia. There are no data on efficacy beyond 4.5 years. (6) These results are somewhat undermined by methodological problems, such as follow-up lasting only a maximum of 4.5 years whereas cervical cancer takes much longer to develop. In addition, there were very few cases of dysplasia in each trial, and results were largely based on post hoc subgroup analyses. (7) Apart from local reactions, which occurred in more than 80% of vaccinated women, the only adverse effect of papillomavirus vaccination was fever (12.9% of those on the vaccine versus 11% on placebo). (8) There is no evidence thus far that prenatal exposure due to HPV vaccination during the month preceding conception is harmful. (9) The clinical results are promising but further follow-up is needed to answer ongoing questions, such as the incidence of cervical cancer after vaccination and the duration of protection. Cervical cancer screening remains necessary, even for vaccinated women, and a continued need exists for measures designed to prevent all sexually transmitted diseases.
PMID: 17582921 [PubMed - indexed for MEDLINE]
Human papillomavirus vaccine for genotypes 6, 11, 16 and 18: new drug. Cervical cancer prevention: high hopes....[No authors listed]
(1) Most cases of high-grade anogenital dysplasia and malignancy are caused by human papillomavirus (HPV) genotypes 16 and 18. Anogenital papilloma and condyloma acuminata are mainly caused by HPV6 and HPV11. (2) A recombinant vaccine covering these four genotypes is now marketed in the European Union for the prevention of condyloma, precancerous lesions, and cancers of the female lower genital tract. (3) A three-dose vaccination schedule (0, 2 and 6 months) elicits an immune response in almost all women, but the minimum antibody titre required for clinical protection is not known. Immune protection lasts at least 5 years, but no one knows what happens after that time. (4) Three double-blind randomised placebo-controlled trials involving a total of about 18 000 women aged 16 to 23 had sufficiently similar designs to pool results for analysis. Nearly all (around 98%) of women not yet infected with papillomavirus of a genotype covered by the vaccine were protected from dysplasia caused by one of these genotypes. The vaccine did not affect dysplasia caused by other genotypes, nor was it effective in women who were already infected. In total, among women not yet infected with a papillomavirus genotype covered by the vaccine, the vaccine prevented about 38% of high-grade dysplasias of all types (0.5 versus 0.8 cases per 100 woman-years). (5) The vaccine also markedly reduced the incidence of genital warts and high-grade vulvar and vaginal dysplasia. There are no data on efficacy beyond 4.5 years. (6) These results are somewhat undermined by methodological problems, such as follow-up lasting only a maximum of 4.5 years whereas cervical cancer takes much longer to develop. In addition, there were very few cases of dysplasia in each trial, and results were largely based on post hoc subgroup analyses. (7) Apart from local reactions, which occurred in more than 80% of vaccinated women, the only adverse effect of papillomavirus vaccination was fever (12.9% of those on the vaccine versus 11% on placebo). (8) There is no evidence thus far that prenatal exposure due to HPV vaccination during the month preceding conception is harmful. (9) The clinical results are promising but further follow-up is needed to answer ongoing questions, such as the incidence of cervical cancer after vaccination and the duration of protection. Cervical cancer screening remains necessary, even for vaccinated women, and a continued need exists for measures designed to prevent all sexually transmitted diseases.
PMID: 17582921 [PubMed - indexed for MEDLINE]
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chichang
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Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
Bull Acad Natl Med. 2007 Dec;191(9):1805-16; discussion 1816-7.Links
[Vaccination against human papillomavirus. Implementation and efficacy against cervical cancer control][Article in French]
Bégué P, Henrion R, Blanc B, Girard M, Sancho-Garnier H.
L'Académie nationale de médecine.
The two new HPV vaccines (Gardasil quadrivalent and Cervarix bivalent 16,11) are both effective against HPV types 16 and 18, which are responsible for 70% of cervical cancers, and the quadrivalent vaccine is effective against HPV 6 and 11, responsible for genital warts. Their efficacy is 100% if they are administered before exposure to HPV 16,18. The proven duration of protection against high-grade cervical lesions is currently 5 years, and the need for boosters is unknown. Cervical cancer screening programs must continue, as only 70% of the 15 high-risk HPV types are targeted. The best age for primary vaccination appears to be 11-12 or 14 years, before the outset of sexual activity. Vaccination of older women is less efficacious, and vaccination of males is being discussed. HPV vaccines should be useful in developing countries, if they can be made available. HPV vaccination campaigns require adequate public information.
PMID: 18663976 [PubMed - indexed for MEDLINE]
[Vaccination against human papillomavirus. Implementation and efficacy against cervical cancer control][Article in French]
Bégué P, Henrion R, Blanc B, Girard M, Sancho-Garnier H.
L'Académie nationale de médecine.
The two new HPV vaccines (Gardasil quadrivalent and Cervarix bivalent 16,11) are both effective against HPV types 16 and 18, which are responsible for 70% of cervical cancers, and the quadrivalent vaccine is effective against HPV 6 and 11, responsible for genital warts. Their efficacy is 100% if they are administered before exposure to HPV 16,18. The proven duration of protection against high-grade cervical lesions is currently 5 years, and the need for boosters is unknown. Cervical cancer screening programs must continue, as only 70% of the 15 high-risk HPV types are targeted. The best age for primary vaccination appears to be 11-12 or 14 years, before the outset of sexual activity. Vaccination of older women is less efficacious, and vaccination of males is being discussed. HPV vaccines should be useful in developing countries, if they can be made available. HPV vaccination campaigns require adequate public information.
PMID: 18663976 [PubMed - indexed for MEDLINE]
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chichang
- 科主任級
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- 來自: pluto
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
Front Biosci. 2007 Jan 1;12:246-64.Links
Vaccines against human papillomavirus.Lin YY, Alphs H, Hung CF, Roden RB, Wu TC.
Department of Pathology, Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, Maryland 21287, USA.
Human papillomavirus has been identified as an etiological factor for cervical cancer, anogenital cancers and a subset of head and neck cancers. These important observations suggest that HPV vaccines have potential in the prevention and treatment of cervical cancer and other HPV-associated malignancies. The HPV genome encodes two HPV late genes, L1 and L2, which form the viral capsid. Early viral proteins support viral genome replication, two of which (E6 and E7) are important for HPV associated malignant transformation. Prophylactic HPV vaccines prevent infection by inducing neutralizing antibodies against HPV capsid proteins L1 and L2. However, because HPV-infected basal keratinocytes and HPV-transformed cells generally do not express L1 or L2, therapeutic HPV vaccines aim to treat established HPV infections and HPV-associated malignancies by targeting non-structural early viral antigens of HPV such as E6 and E7. Results from preclinical HPV vaccine studies have led to several HPV vaccine clinical trials. If these prophylactic and therapeutic HPV vaccines prove as successful in patients as they have in animal models, vaccination may provide for control and eventually eradication of oncogenic HPV infection and HPV-related cancers.
PMID: 17127297 [PubMed - indexed for MEDLINE]
Vaccines against human papillomavirus.Lin YY, Alphs H, Hung CF, Roden RB, Wu TC.
Department of Pathology, Johns Hopkins Medical Institutions, 600 North Wolfe Street, Baltimore, Maryland 21287, USA.
Human papillomavirus has been identified as an etiological factor for cervical cancer, anogenital cancers and a subset of head and neck cancers. These important observations suggest that HPV vaccines have potential in the prevention and treatment of cervical cancer and other HPV-associated malignancies. The HPV genome encodes two HPV late genes, L1 and L2, which form the viral capsid. Early viral proteins support viral genome replication, two of which (E6 and E7) are important for HPV associated malignant transformation. Prophylactic HPV vaccines prevent infection by inducing neutralizing antibodies against HPV capsid proteins L1 and L2. However, because HPV-infected basal keratinocytes and HPV-transformed cells generally do not express L1 or L2, therapeutic HPV vaccines aim to treat established HPV infections and HPV-associated malignancies by targeting non-structural early viral antigens of HPV such as E6 and E7. Results from preclinical HPV vaccine studies have led to several HPV vaccine clinical trials. If these prophylactic and therapeutic HPV vaccines prove as successful in patients as they have in animal models, vaccination may provide for control and eventually eradication of oncogenic HPV infection and HPV-related cancers.
PMID: 17127297 [PubMed - indexed for MEDLINE]
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chichang
- 科主任級
- 文章: 5470
- 註冊時間: 週二 5月 06, 2008 5:32 pm
- 來自: pluto
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
CMAJ. 2007 Aug 28;177(5):469-79. Epub 2007 Aug 1. Links
Comment in:
CMAJ. 2007 Dec 4;177(12):1525-6; author reply 1527-8.
Evid Based Nurs. 2008 Jan;11(1):11.
Prophylactic vaccination against human papillomavirus infection and disease in women: a systematic review of randomized controlled trials.Rambout L, Hopkins L, Hutton B, Fergusson D.
Department of Pharmacy, The Ottawa Hospital, Ottawa, Ont. [email protected]
BACKGROUND: Human papillomavirus (HPV) is now known to be a necessary cause of cervical cancer, and prophylactic HPV vaccines aimed at preventing genital warts, precancerous cervical lesions and cervical cancer are now available. To gauge the potential impact on disease burden, we performed a systematic review of the evidence from randomized controlled trials. METHODS: We conducted a systematic search of the literature to identify all randomized controlled trials of prophylactic HPV vaccination. Reports in 5 electronic databases covering 1950 to June 2007 (MEDLINE, MEDLINE in process, EMBASE, the Cochrane Central Registry of Controlled Trials and the Cochrane Library), bibliographies of all included studies and of narrative reviews (2006-2007), clinical trial registries, Google Scholar, public health announcements, selected conference proceedings (2004-2007) and manufacturers' information on unpublished data or ongoing trials were screened against predefined eligibility criteria by 2 independent reviewers. Vaccines had to contain coverage against at least 1 oncogenic HPV strain. The primary outcome of interest was the frequency of high-grade cervical lesions (high-grade squamous intraepithelial lesion, or grade 2 or 3 cervical intraepithelial neoplasia). The secondary outcomes were persistent HPV infection, low-grade cervical lesions (low-grade squamous intraepithelial lesion or grade 1 cervical intraepithelial neoplasia), external genital lesions, adverse events and death. Meta-analysis of the data was done in all cases where adequate clinical and methodological homogeneity existed. RESULTS: Of 456 screened reports, 9 were included in the review (6 were reports of randomized controlled trials and 3 were follow-up reports of initial trials). Findings from the meta-analysis showed that prophylactic HPV vaccination was associated with a reduction in the frequency of high-grade cervical lesions caused by vaccine-type HPV strains compared with control groups: Peto odds ratio 0.14 (95% confidence interval [CI] 0.09-0.21) from combined per-protocol analyses, and 0.52 (95% CI 0.43-0.63) from modified intention-to-treat analyses. Vaccination was also highly efficacious in preventing other HPV-related infection and disease outcomes, including persistent HPV infection, low-grade lesions and genital warts. The majority of adverse events were minor. The incidence of serious adverse events and death were balanced between the vaccine and control groups. INTERPRETATION: Among women aged 15-25 years not previously infected with vaccine-type HPV strains, prophylactic HPV vaccination appears to be highly efficacious in preventing HPV infection and precancerous cervical disease. Long-term follow-up is needed to substantiate reductions in cervical cancer incidence and mortality.
PMID: 17671238 [PubMed - indexed for MEDLINE]
PMCID: PMC1950172
Comment in:
CMAJ. 2007 Dec 4;177(12):1525-6; author reply 1527-8.
Evid Based Nurs. 2008 Jan;11(1):11.
Prophylactic vaccination against human papillomavirus infection and disease in women: a systematic review of randomized controlled trials.Rambout L, Hopkins L, Hutton B, Fergusson D.
Department of Pharmacy, The Ottawa Hospital, Ottawa, Ont. [email protected]
BACKGROUND: Human papillomavirus (HPV) is now known to be a necessary cause of cervical cancer, and prophylactic HPV vaccines aimed at preventing genital warts, precancerous cervical lesions and cervical cancer are now available. To gauge the potential impact on disease burden, we performed a systematic review of the evidence from randomized controlled trials. METHODS: We conducted a systematic search of the literature to identify all randomized controlled trials of prophylactic HPV vaccination. Reports in 5 electronic databases covering 1950 to June 2007 (MEDLINE, MEDLINE in process, EMBASE, the Cochrane Central Registry of Controlled Trials and the Cochrane Library), bibliographies of all included studies and of narrative reviews (2006-2007), clinical trial registries, Google Scholar, public health announcements, selected conference proceedings (2004-2007) and manufacturers' information on unpublished data or ongoing trials were screened against predefined eligibility criteria by 2 independent reviewers. Vaccines had to contain coverage against at least 1 oncogenic HPV strain. The primary outcome of interest was the frequency of high-grade cervical lesions (high-grade squamous intraepithelial lesion, or grade 2 or 3 cervical intraepithelial neoplasia). The secondary outcomes were persistent HPV infection, low-grade cervical lesions (low-grade squamous intraepithelial lesion or grade 1 cervical intraepithelial neoplasia), external genital lesions, adverse events and death. Meta-analysis of the data was done in all cases where adequate clinical and methodological homogeneity existed. RESULTS: Of 456 screened reports, 9 were included in the review (6 were reports of randomized controlled trials and 3 were follow-up reports of initial trials). Findings from the meta-analysis showed that prophylactic HPV vaccination was associated with a reduction in the frequency of high-grade cervical lesions caused by vaccine-type HPV strains compared with control groups: Peto odds ratio 0.14 (95% confidence interval [CI] 0.09-0.21) from combined per-protocol analyses, and 0.52 (95% CI 0.43-0.63) from modified intention-to-treat analyses. Vaccination was also highly efficacious in preventing other HPV-related infection and disease outcomes, including persistent HPV infection, low-grade lesions and genital warts. The majority of adverse events were minor. The incidence of serious adverse events and death were balanced between the vaccine and control groups. INTERPRETATION: Among women aged 15-25 years not previously infected with vaccine-type HPV strains, prophylactic HPV vaccination appears to be highly efficacious in preventing HPV infection and precancerous cervical disease. Long-term follow-up is needed to substantiate reductions in cervical cancer incidence and mortality.
PMID: 17671238 [PubMed - indexed for MEDLINE]
PMCID: PMC1950172
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fredguo
- R1
- 文章: 150
- 註冊時間: 週六 5月 17, 2008 10:01 am
- 來自: 台北市
- 聯繫:
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
除了價格以外，子宮頸癌疫苗還有效期的問題
目前沒有人知道保護力能維持多久
有哈佛的學者分析如果效期可以超過10年，有cost-benefit
沒有到10年，他就不敢保證了
用公共衛生的錢來打可能將來還要準備booster的費用
這是政府要有心理準備的
否則可能還是先當自費疫苗打
但是還是列入建議施打的疫苗
等將來廠商降價再說
不過台灣民眾做子宮頸抹片的比率一直不理想
如何增加經費宣傳，甚至做抹片發消費卷
可能會比打疫苗更有cost-benefit
畢竟打了疫苗還是要做抹片的（有些HPV病毒株沒有cover）
所有的專家都這麼說
家裡有小孩的還是先打了再說
就算要booster我覺得還是划算的
要等國家免費打，在目前國家財政的狀況下
恐怕有得等了..........
目前沒有人知道保護力能維持多久
有哈佛的學者分析如果效期可以超過10年，有cost-benefit
沒有到10年，他就不敢保證了
用公共衛生的錢來打可能將來還要準備booster的費用
這是政府要有心理準備的
否則可能還是先當自費疫苗打
但是還是列入建議施打的疫苗
等將來廠商降價再說
不過台灣民眾做子宮頸抹片的比率一直不理想
如何增加經費宣傳，甚至做抹片發消費卷
可能會比打疫苗更有cost-benefit
畢竟打了疫苗還是要做抹片的（有些HPV病毒株沒有cover）
所有的專家都這麼說
家裡有小孩的還是先打了再說
就算要booster我覺得還是划算的
要等國家免費打，在目前國家財政的狀況下
恐怕有得等了..........
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Nicholas
- 院長級
- 文章: 27051
- 註冊時間: 週三 11月 08, 2006 6:50 pm
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fredguo
- R1
- 文章: 150
- 註冊時間: 週六 5月 17, 2008 10:01 am
- 來自: 台北市
- 聯繫:
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
對於國家的錢要如何花
常常有很深的感慨
台灣目前一年死於菸害的有兩萬人
幾乎是1/5的死亡人口
但是戒菸門診的經費只編區區的8千萬
還要醫生不准看戒菸病人........... （阿飄）
如果真的通過公費注射子宮頸癌疫苗
至少是上百億元的經費吧
就因為這是比較熱門的話題
而且沒有菸商立委攪局
其實效用決對沒有投資戒菸服務高
真令人氣餒
別忘了吸菸也是子宮頸癌的危險因子喔 .........
常常有很深的感慨
台灣目前一年死於菸害的有兩萬人
幾乎是1/5的死亡人口
但是戒菸門診的經費只編區區的8千萬
還要醫生不准看戒菸病人........... （阿飄）
如果真的通過公費注射子宮頸癌疫苗
至少是上百億元的經費吧
就因為這是比較熱門的話題
而且沒有菸商立委攪局
其實效用決對沒有投資戒菸服務高
真令人氣餒
別忘了吸菸也是子宮頸癌的危險因子喔 .........
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歌劇迷
- 註冊會員
- 文章: 3932
- 註冊時間: 週日 1月 21, 2007 6:56 pm
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
請問會有副作用嗎？ 我的手因為經常有傷口，所以容易長疣.....請問這個針劑是否可以預防？
如果不方便作答，請忽略我的提問。
還是謝謝 (跪拜禮new)
如果不方便作答，請忽略我的提問。
還是謝謝 (跪拜禮new)
"No one can make you feel inferior without your consent."--Eleanor Roosevelt
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fredguo
- R1
- 文章: 150
- 註冊時間: 週六 5月 17, 2008 10:01 am
- 來自: 台北市
- 聯繫:
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
NEJM 的夠好了嗎？Nicholas 寫:這些journal都不是非常主流
說服力不夠高
http://content.nejm.org/cgi/content/abs ... 56/19/1915
http://content.nejm.org/cgi/content/abs ... 56/19/1928
這兩篇才是真正original的文章，其他只是評論跟review而已
另一家廠牌的在這裡
http://www.thelancet.com/journals/lance ... 5/abstract
還有 meta-analysis的
http://www.thelancet.com/journals/lance ... 6/fulltext
Lancet，也夠好了吧 ........ （窮）
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fredguo
- R1
- 文章: 150
- 註冊時間: 週六 5月 17, 2008 10:01 am
- 來自: 台北市
- 聯繫:
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
已經得過了歌劇迷 寫:請問會有副作用嗎？ 我的手因為經常有傷口，所以容易長疣.....請問這個針劑是否可以預防？
如果不方便作答，請忽略我的提問。
還是謝謝 (跪拜禮new)
就不能預防了 ....... JAMA 有文獻證實
http://jama.ama-assn.org/cgi/content/full/298/7/743
像我這樣一夫一妻的
大概也不用打了
如果還在打野食的
不妨打一下
男生也有用喔 ..........
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chichang
- 科主任級
- 文章: 5470
- 註冊時間: 週二 5月 06, 2008 5:32 pm
- 來自: pluto
-
pinging
- R3
- 文章: 390
- 註冊時間: 週四 1月 24, 2008 12:13 pm
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
當初台灣開始要推全面B型肝炎疫苗接種時
也有很多反對的聲音
其中包括兒科專家
那時候未知數更多，包括這裡討論的有效期、能否降低B肝癌發生率等
大家對於世界上第一個國家這樣做「試驗」也很不放心
但後來台灣經驗變成台灣之光，大家忘了那些異議者可能造成的傷害
反對疫苗是常見的行為
大家必須有能力判斷是非
不必看期刊有沒有名氣
只要看一下，全世界已經有27個先進國家開始免費人類乳突病毒疫苗
他們不會傻到不懂反對意見所講的那些
也有很多反對的聲音
其中包括兒科專家
那時候未知數更多，包括這裡討論的有效期、能否降低B肝癌發生率等
大家對於世界上第一個國家這樣做「試驗」也很不放心
但後來台灣經驗變成台灣之光，大家忘了那些異議者可能造成的傷害
反對疫苗是常見的行為
大家必須有能力判斷是非
不必看期刊有沒有名氣
只要看一下，全世界已經有27個先進國家開始免費人類乳突病毒疫苗
他們不會傻到不懂反對意見所講的那些
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Dr. W
- V1
- 文章: 1159
- 註冊時間: 週一 9月 11, 2006 10:55 am
- 來自: 台北
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
+1pinging 寫:當初台灣開始要推全面B型肝炎疫苗接種時
也有很多反對的聲音
其中包括兒科專家
那時候未知數更多，包括這裡討論的有效期、能否降低B肝癌發生率等
大家對於世界上第一個國家這樣做「試驗」也很不放心
但後來台灣經驗變成台灣之光，大家忘了那些異議者可能造成的傷害
反對疫苗是常見的行為
大家必須有能力判斷是非
不必看期刊有沒有名氣
只要看一下，全世界已經有27個先進國家開始免費人類乳突病毒疫苗
他們不會傻到不懂反對意見所講的那些
-
albarto1688
- V2
- 文章: 2297
- 註冊時間: 週六 11月 04, 2006 5:55 pm
- 來自: Crazy Island
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
+2Dr. W 寫:+1pinging 寫:當初台灣開始要推全面B型肝炎疫苗接種時
也有很多反對的聲音
其中包括兒科專家
那時候未知數更多，包括這裡討論的有效期、能否降低B肝癌發生率等
大家對於世界上第一個國家這樣做「試驗」也很不放心
但後來台灣經驗變成台灣之光，大家忘了那些異議者可能造成的傷害
反對疫苗是常見的行為
大家必須有能力判斷是非
不必看期刊有沒有名氣
只要看一下，全世界已經有27個先進國家開始免費人類乳突病毒疫苗
他們不會傻到不懂反對意見所講的那些
-
歌劇迷
- 註冊會員
- 文章: 3932
- 註冊時間: 週日 1月 21, 2007 6:56 pm
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
謝謝回應。fredguo 寫:已經得過了歌劇迷 寫:請問會有副作用嗎？ 我的手因為經常有傷口，所以容易長疣.....請問這個針劑是否可以預防？
如果不方便作答，請忽略我的提問。
還是謝謝 (跪拜禮new)
就不能預防了 ....... JAMA 有文獻證實
http://jama.ama-assn.org/cgi/content/full/298/7/743
像我這樣一夫一妻的
大概也不用打了
如果還在打野食的
不妨打一下
男生也有用喔 ..........
1. 所以這個針劑的確可以預防手上的疣？得過了，就沒效了？ (不要啊)
2. 手上長疣跟性行為有關聯嗎？ 好像應該沒有捏...... (推眼鏡)
"No one can make you feel inferior without your consent."--Eleanor Roosevelt
-
chichang
- 科主任級
- 文章: 5470
- 註冊時間: 週二 5月 06, 2008 5:32 pm
- 來自: pluto
Re: 子宮頸疫苗不一定管用？醫師：疫苗強烈被證明有效
HPV 有很130多種。這個疫苗主要是發展來對抗跟子宮頸癌有關的HPV 16, 18歌劇迷 寫: 1. 所以這個針劑的確可以預防手上的疣？得過了，就沒效了？ (不要啊)
2. 手上長疣跟性行為有關聯嗎？ 好像應該沒有捏...... (推眼鏡)
手上的大多是 2, 4 ， 腳上的大多是 1 ，臉上扁平疣是 3, 10
有興趣進一步了解HPV的話，可以參考 WIKI 人類乳突病毒
醫師同仁可以看英文版的，可以獲得更多的信息。
http://en.wikipedia.org/wiki/Human_papillomavirus