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Garacia Marques

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El Virus del Papiloma Humano y la vacuna para prevenir el cáncer cérvico uterino: descripción y prevención de la enfermedad

No. DE AUTORIZACION: 093300201B1730 SSA

lunes 20 de septiembre de 2010

El cáncer cérvico uterino

P1

lunes 20 de septiembre de 2010

¿Dónde se desarrolla el cáncer cérvico uterino?

El cáncer cérvico uterino se desarrolla en el cérvix, también conocido como cuello de la matriz o cuello uterino.
P3

lunes 20 de septiembre de 2010

¿Cuántas mujeres mueren por cáncer cérvico uterino?
Una mujer muere por cáncer cérvico uterino cada 2 minutos en el mundo…

México 13,000 6,000

NA+Europa 75,000 36,000

Asia 266,000 143,000 África

En México es la 1a causa de muerte por cáncer en mujeres > 25 años.
Nuevos casos cada año: ˜500,000 Muertes cada año: ˜270,000

América Latina

79,000 62,000

72,000 33,000

…y cada 2 horas en México
P2

lunes 20 de septiembre de 2010

¿Cómo se puede prevenir el cáncer cérvico uterino?

Prevención primaria:
Aplicación de una vacuna para prevenir la infección inicial por VPH

Prevención secundaria
Detección oportuna para el diagnóstico y eventualmente tratamiento temprano de lesiones precancerosas asociadas con VPH

Las principales pruebas de detección son:
• Papanicolaou
• Colposcopía • Otras pruebas tipo ADN

P4

lunes 20 de septiembre de 2010

¿Qué es el prueba de Papanicolaou?

Se raspan las células del cuello uterino y se examinan bajo el microscopio para determinar la presencia de lesiones
Dr. Papanicolaou

Se pueden detectar células anormales en una etapa temprana

Las intervenciones de seguimiento efectivo pueden prevenir el desarrollo de cáncer cérvico uterino
Cuello uterino visto por el espéculo, con la paciente en posición de litotomía

P5

lunes 20 de septiembre de 2010

¿Cómo evoluciona el cáncer cérvico uterino? (esquema)

NIC 1, 2, 3: Neoplasia Intraepitelial Cervicouterina de grado 1, 2, 3. LEIBG o LEIAG: Lesiones Escamosas Intraepiteliales de Bajo Grado o Alto Grado.

P6

lunes 20 de septiembre de 2010

¿Cómo evoluciona el cáncer cérvico uterino? (fotos del cérvix)

NIC 1, 2, 3: Neoplasia Intraepitelial Cervicouterina de grado 1, 2, 3. LEIBG o LEIAG: Lesiones Escamosas Intraepiteliales de Bajo Grado o Alto Grado.

P7

lunes 20 de septiembre de 2010

¿Cuál es la causa del cáncer cérvico uterino?

Virus del Papiloma Humano

Foto de cérvix con Cáncer (mujer de 24 años)

.

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El Virus del Papiloma Humano

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¿Cuántos tipos de VPH existen?
Existen aproximadamente 100 tipos de VPH, de los cuales 15 están clasificados como oncogénicos (es decir que causan cáncer)
• Globalmente, los tipos VPH 16 y 18 son los responsables en conjunto de más del 70% de los casos de cáncer cérvico uterino • Los siguientes en orden de importancia son los tipos VPH 31,33 y 45
Representación gráfica

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¿Cuáles son los tipos de VPH más frecuentes?

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¿Cómo evoluciona la infección por VPH?

Infección por VPH
Tipos de bajo riesgo 6, 11, otros Verrugas genitales

Tipos oncogénicos (o de alto riesgo) 16, 18, 45, 31, otros Infección del cérvix

Regresión

Terapia

NIC 1 / 2 Regresión

NIC 2 / 3 Cáncer cérvico uterino
P9

NIC 1, 2, 3: Neoplasia Intraepitelial Cervicouterina de grado 1, 2, 3.

lunes 20 de septiembre de 2010

¿Cuáles son los tipos de VPH más frecuentes según el tipo de cáncer?

Cáncer (o carcinoma) localizado en la parte externa del cérvix Adenocarcinoma cáncer más agresivo y más difícil de detectar, localizado en la parte interna del cérvix

P13

lunes 20 de septiembre de 2010

¿Qué tan frecuente es la infección por VPH?
Se estima que 50 a 80% de las mujeres adquirirán una infección por VPH durante su vida Más del 80% de las infecciones por VPH son pasajeras, sin síntomas y se resuelven espontáneamente. Otras pueden progresar a cáncer cérvico uterino El cáncer cérvico uterino es causado por la infección persistente por VPH.

P14

lunes 20 de septiembre de 2010

¿Qué otros factores contribuyen a la infección por VPH?

Los cofactores pueden tener un papel importante en la progresión de la infección por VPH a lesiones cérvico uterinas • Número de compañeros sexuales durante la vida • Edad temprana al momento de la primera relación sexual • Fumar • Uso de anticonceptivos orales por tiempo prolongado • Otras infecciones de transmisión sexual • Elevado número de embarazos

P15

lunes 20 de septiembre de 2010

¿Cuál es el riesgo de infectarme?
El riesgo inicia cuando empiezan las relaciones sexuales y sigue presente a

lo largo de la vida fácilmente

La infección por VPH se transmite muy La adquisición es por contacto

sexual a nivel genital piel con piel (no

es necesaria una relación con penetración para infectarse) Los condones reducen el riesgo, pero no son totalmente efectivos

Cualquier persona que sea (o será en el futuro) sexualmente activa, está en riesgo de exposición a los tipos de VPH oncogénicos (que causan cáncer)

P16

lunes 20 de septiembre de 2010

La vacuna de GlaxoSmithKline para la prevención del cáncer cérvico uterino

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¿Qué debe proporcionar una vacuna para prevenir el cáncer cérvico uterino?
Una vacuna para prevenir el cáncer cérvico uterino debe ofrecer: Una protección fuerte y duradera Una cobertura amplia para prevenir la infección por tipos de VPH oncogénicos Una protección para mujeres de un amplio rango de edad. Un excelente perfil de seguridad

P18

lunes 20 de septiembre de 2010

¿Qué perfil tiene la vacuna de GlaxoSmithKline?
Composición de la vacuna:
• VPH 16 y 18 • Sistema Adyuvante AS04 para proporcionar una protección fuerte y duradera

Eficacia de la vacuna:
• La vacuna ofrece una eficacia de 100% contra VPH 16 y 18, y una protección adicional contra otros tipos de VPH oncogénicos como el 45 y 31, cubriendo así más del 80% de los casos de cáncer cérvico uterino

P19

lunes 20 de septiembre de 2010

¿Qué perfil tiene la vacuna de GlaxoSmithKline?

Perfil del paciente:
Mujeres de 10 a 55 años

Segura y bien tolerada en los estudios clínicos con más de 45,000 mujeres alrededor del mundo

Embarazo??
No se recomienda la vacunación durante el embarazo.

P19

lunes 20 de septiembre de 2010

Efectos esperados

Reacciones esperadas:
Dolor, enrojecimiento e hinchazón en La zona de aplicación. En algunas mujeres se puede presentar dolor de cabeza y dolor muscular de corta duración.

P19

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¿Cuántas dosis me tengo que aplicar y cuándo?

3 dosis por inyección intramuscular en el brazo
P22

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¿Qué es un adyuvante y por qué necesitamos sistemas de adyuvantes novedosos?

Vacuna Antígeno
Desencadena la respuesta inmune “Defensas del cuerpo”

Adyuvante
Sustancia que potencializa la respuesta inmune al antígeno

El adyuvante puede incrementar la intensidad, la calidad y el tipo de respuesta inmune, haciéndola más fuerte y con mayor duración. La vacuna de GSK contiene un novedoso Sistema Adyuvante llamado AS04

P20

lunes 20 de septiembre de 2010

¿Cual es la eficacia de la vacuna?
Casos
Vacuna

NIC2+ asociados con VPH 16/18
Estudio inicial de eficacia Análisis combinado del estudio inicial de eficacia y seguimiento extendido

Control n

Eficacia de la vacuna % IC 95%

n

2.2 años1 4.5 años2 5.5 años3,4 6.4 años5
NIC2+ = NIC2, NIC3, adenocarcinoma in situ y el cáncer cérvico-uterino

P21

lunes 20 de septiembre de 2010

¿Cual es la eficacia de la vacuna?
Casos
Vacuna

NIC2+ asociados con VPH 16/18
Estudio inicial de eficacia Análisis combinado del estudio inicial de eficacia y seguimiento extendido

Control n

Eficacia de la vacuna % IC 95% NA

n

2.2 años1 4.5 años2 5.5 años3,4 6.4 años5
NIC2+ = NIC2, NIC3, adenocarcinoma in situ y el cáncer cérvico-uterino

0

3

100

P21

lunes 20 de septiembre de 2010

¿Cual es la eficacia de la vacuna?
Casos
Vacuna

NIC2+ asociados con VPH 16/18
Estudio inicial de eficacia Análisis combinado del estudio inicial de eficacia y seguimiento extendido

Control n

Eficacia de la vacuna % IC 95% NA -7.7 - 100

n

2.2 años1 4.5 años2 5.5 años3,4 6.4 años5
NIC2+ = NIC2, NIC3, adenocarcinoma in situ y el cáncer cérvico-uterino

0 0

3 5

100 100

P21

lunes 20 de septiembre de 2010

¿Cual es la eficacia de la vacuna?
Casos
Vacuna

NIC2+ asociados con VPH 16/18
Estudio inicial de eficacia Análisis combinado del estudio inicial de eficacia y seguimiento extendido

Control n

Eficacia de la vacuna % IC 95% NA -7.7 - 100 32.7 - 100

n

2.2 años1 4.5 años2 5.5 años3,4 6.4 años5
NIC2+ = NIC2, NIC3, adenocarcinoma in situ y el cáncer cérvico-uterino

0 0 0

3 5 7

100 100 100

P21

lunes 20 de septiembre de 2010

¿Cual es la eficacia de la vacuna?
Casos
Vacuna

NIC2+ asociados con VPH 16/18
Estudio inicial de eficacia Análisis combinado del estudio inicial de eficacia y seguimiento extendido

Control n

Eficacia de la vacuna % IC 95% NA -7.7 - 100 32.7 - 100 51.3 - 100

n

2.2 años1 4.5 años2 5.5 años3,4 6.4 años5
NIC2+ = NIC2, NIC3, adenocarcinoma in situ y el cáncer cérvico-uterino

0 0 0 0

3 5 7 9

100 100 100 100

P21

lunes 20 de septiembre de 2010

¿Qué beneficios proporciona la vacuna?

Protección fuerte contra tipos de VPH oncogénicos. La protección es más fuerte y duradera que cuando se adquiere una infección natural.

La vacuna cuenta con resultados de eficacia a largo plazo. Se estima que la protección puede durar al menos 20 años.

P21

lunes 20 de septiembre de 2010

¿En conclusión, cuál es la prevención ideal?
La prevención ideal del cáncer cérvico uterino debe combinar:

Una vacuna segura que ofrece: una protección fuerte y duradera en mujeres a partir de los 10 hasta los 55 años de edad La detección oportuna a través de las pruebas de detección temprana (como Papanicolaou) en intervalos regulares

P23

lunes 20 de septiembre de 2010

Un regalo de vida para ti y tu familia...
Tú tienes la última palabra para evitar que el cáncer cérvico uterino entre a tu vida.

CONSULTA A TU MEDICO

¡Vacúnate ya!
Visita nuestra página:

www.gsk-cancercervicouterino.com.mx
No. DE AUTORIZACION: 093300201B1730 SSA

lunes 20 de septiembre de 2010

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