台灣邁向消除子宮頸癌的現況與展望

Current Status and Future Prospects Towards the Elimination of Cervical Cancer in Taiwan

子宮頸癌是女性健康的重要威脅，2022年全球約有66萬新病例與35萬死亡案例，多數發生於醫療資源不足的中低收入國家。其致病關鍵在於高風險型人類乳突病毒感染，雖然90%的感染能被免疫系統清除，但持續感染可能逐漸形成癌前病變並進展為癌症。由於此過程通常需多年時間，因此疫苗接種與定期篩檢成為防治關鍵。世界衛生組織提出「90-70-90」策略，即90%女孩完成HPV（human papillomavirus）疫苗接種、70%女性接受至少兩次篩檢、90%確診病人獲得治療，以降低子宮頸癌發生率。臺灣目前的雖然防治成效顯著，然而要達成「年發生率每10萬人小於4人」的消除標準仍具挑戰，未來應針對高風險或篩檢率低的族群加強衛教，解決民眾因缺乏自覺或心理門檻而產生的「防治斷層」。預期在政策持續優化下，臺灣有望於2050年達成子宮頸癌消除目標。

Cervical cancer remains a significant threat to women's health. In 2022, there were approximately 660,000 new cases and 350,000 deaths globally, the majority of which occurred in low- and middle-income countries with limited medical resources. The key of pathogenesis of cervical cancer lies in persistent infection with high-risk human papillomavirus (HPV); although 90% of infections are cleared by the immune system, chronic infection can gradually lead to precancerous lesions and progress into malignancy. Since the progression typically spans several years, vaccination and regular screening are the cornerstones of cervical cancer prevention. The World Health Organization (WHO) has proposed the ''90-70-90'' strategy: 90% of girls fully vaccinated with the HPV vaccine, 70% of women screened with a high-performance test at least twice, and 90% of diagnosed patients receiving treatment, all aimed at reducing the incidence of cervical cancer. While Taiwan has achieved significant success in its prevention efforts, reaching the elimination standard of ''fewer than 4 cases per 100,000 people annually'' remains a challenge. Future strategies should focus on strengthening health education for high-risk or low-screening-rate populations to bridge the ''prevention gap'' caused by a lack of awareness or psychological barriers. With continuous policy optimization, Taiwan is expected to achieve the goal of eliminating cervical cancer by 2050.