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Vol. 55. Núm. S1.
Vacunación frente al cáncer de cérvix en mujeres fuera de los programas de vacunación sistemática, con o sin infección por el virus del papiloma humano o lesión cervical. Encuesta de opinión y recomendaciones
Páginas 10-31 (Septiembre 2012)
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Vol. 55. Núm. S1.
Vacunación frente al cáncer de cérvix en mujeres fuera de los programas de vacunación sistemática, con o sin infección por el virus del papiloma humano o lesión cervical. Encuesta de opinión y recomendaciones
Páginas 10-31 (Septiembre 2012)
Acceso a texto completo
Vacunación frente al cáncer de cérvix en mujeres fuera de los programas de vacunación sistemática, con o sin infección por el virus del papiloma humano o lesión cervical. Encuesta de opinión y recomendaciones
Vaccination against cervical cancer in women outside of routine immunization programs, with or without infection by the human papilloma virus or cervical lesions. Opinion survey and recommendations
Visitas
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Aureli Torné Bladéa,
Autor para correspondencia
aureli@comb.cat

Autor para correspondencia.
, José María Bayas Rodríguezb, Xavier Castellsagué Piquéc, María Castro Sánchezd, Enrique García Garcíae, Juan Carlos Martínez Escorizaf, Luis María Puig-Tintorég, Alfonso Quesada López-Feh, José Antonio Vidart Aragóni
a Unidad de Ginecología Oncológica, Instituto Clínico de Ginecología y Obstetricia y Neonatología (ICGON), Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Facultad de Medicina, Universidad de Barcelona, Barcelona, España
b Centro de Vacunación de Adultos, Servicio de Medicina Preventiva y Epidemiología, Hospital Clínic, Barcelona, España
c Unidad de Infecciones y Cáncer, Programa de Investigación en Epidemiología del Cáncer, Institut Català d’Oncologia (ICO)-IDIBELL, CIBER-ESP, L’Hospitalet de Llobregat, Barcelona, España
d Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España
e Servicio de Ginecología, Instituto Valenciano de Oncología, Valencia, España
f Servicio de Obstetricia y Ginecología, Hospital General Universitario de Alicante, Alicante, España
g Profesor de Ginecología, Facultad de Medicina, Universidad de Barcelona, Barcelona, España
h Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
i Servicio de Obstetricia y Ginecología, Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
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Resumen

Las vacunas frente al cáncer de cérvix se han implementado, en un amplio número de países del mundo, dentro de los programas de vacunación sistemática. Asimismo se ha recomendado la vacunación de rescate en adolescentes y mujeres jóvenes. Desde la perspectiva de salud pública, la vacunación rutinaria en mujeres de mayor edad no se plantea por motivos de coste-efectividad. En estos casos son el médico y la paciente los que, de forma individualizada, deben decidir sobre la vacunación.

Una encuesta de opinión dirigida a ginecólogos españoles que desarrollan su actividad asistencial en el ámbito de la patología cervical y colposcopia evidencia que, incluso en este colectivo, hay un relativo desconocimiento sobre aspectos importantes de la vacuna frente al cáncer de cérvix en mujeres fuera de los programas de vacunación sistemática, con o sin infección por el virus del papiloma humano (VPH) o lesión cervical. Además se constata la demanda de mayor información y poder disponer de recomendaciones específicas acerca de este tema.

En el presente artículo se revisan las evidencias sobre la infección VPH y el riesgo de cáncer de cérvix a lo largo de la vida, la eficacia de las vacunas en relación con la edad o tras el tratamiento de lesiones cervicales, y la perspectiva del médico y de la mujer. Finalmente se presentan unas recomendaciones, a modo de guía clínica, sobre la vacunación en mujeres fuera de los programas de vacunación sistemática, con o sin infección o lesión cervical.

Palabras clave:
Vacuna frente al VPH
Riesgo VPH
Cáncer de cérvix
Mujer adulta
Recomendación
Abstract

Vaccines against cervical cancer have been implemented in a wide number of countries around the world as part of systematic vaccination programmes. In addition, rescue vaccination has been recommended for teenagers and young women. From a Public Health perspective, routine vaccination in older women is not proposed for reasons of cost-effectiveness. In these cases, the physician and the patient must decide about the suitability of vaccination in each individual.

An opinion poll of Spanish gynaecologists rendering health-care services in the area of cervical pathologies and colposcopy has shown that, even among this group, there is relative lack of knowledge about important aspects of the vaccine against cervical cancer in women outside systematic vaccination programmes, with or without HPV infection or cervical lesions. In addition, the demand for greater information has been confirmed, as has the wish for specific recommendations on this topic.

The present article reviews the evidence on HPV infection and the lifelong risk of cervical cancer, the efficacy of vaccines with respect to age or after the treatment of cervical lesions and the perspectives of physicians and women. Finally, some recommendations are made by way of clinical guidance for the vaccination of women outside systematic vaccination programmes, with or without infection or cervical lesion.

Keywords:
HPV vaccine
HPV risk
Cervical cancer
Adult women
Recommendation
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