2014-2019年大连市农村地区宫颈癌筛查数据分析
Analysis of cervical cancer screening results of rural women in Dalian City from 2014 to 2019
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摘要: 目的 分析2014-2019年大连市农村地区宫颈癌检查项目数据,了解大连市农村地区宫颈癌筛查情况,评价不同初筛方法的检出效果,为进一步做好宫颈癌防治工作提供科学建议。方法 数据来源于妇幼重大公共卫生服务项目信息直报系统中2014-2019年大连市农村地区宫颈癌筛查数据,初筛方法包括宫颈细胞学检查(巴氏涂片、液基细胞学检查)和HPV检测,采用χ2检验比较不同初筛方法和不同年份的初筛阳性率、宫颈癌和癌前病变检出率、早诊率等指标。结果 2014-2019年共有149 918名35~64岁农村妇女进行了免费宫颈癌检查,初筛阳性人数8984人,阳性率为5. 99%;共检出宫颈癌前病变799例,检出率为532. 96/10万;宫颈癌41例,检出率为27. 35/10万;检出早期宫颈癌9例,早诊率为96. 19%。两种不同初筛方法比较:HPV检测初筛阳性率(10. 13%)、低级别鳞状上皮内病变检出率(713. 41/10万)、高级别鳞状上皮内病变检出率(675. 02/10万)、宫颈癌前病变检出率(679. 82/10万)均高于宫颈细胞学检查相应指标值[细胞学初筛阳性率(3. 04%)、低级别鳞状上皮内病变检出率(609. 83/10万)、高级别鳞状上皮内病变检出率(424. 48/10万)、宫颈癌前病变检出率(427. 91/10万)],且差异具有统计学意义(P<0. 05)。结论 2014-2019年大连市农村地区宫颈癌检查成效明显;与宫颈细胞学检查比较,以HPV检测为初筛方法的宫颈癌检查策略可以更好地发现宫颈癌前病变,便于更早进行随访管理。各区县应结合本地实际情况制定科学、高效和可行的宫颈癌检查方案。Abstract: Objective To analyze the screening data of cervical cancer in rural areas of Dalian from 2014 to 2019, to understand the screening effect of cervical cancer in rural areas of Dalian, and to evaluate the detection effect of different screening methods, so as to provide scientific suggestions for the prevention and treatment of cervical cancer. Method The data were obtained from the data of the cervical cancer screening in rural areas of Dalian from 2014 to 2019 in the information reporting system of major public health services for women and children. The primary screening methods included cervical cytology tests(Pap smear, liquid-based cytology) and HPV test. The Chi-square test was used to compare the positive rate of primary screening, the detection rate of cervical cancer and precancerous lesions and the early diagnosis rate between different screening methods and years. Result A total of 149,918 rural women aged 35-64 years old were screened for cervical cancer free of charge in 2014-2019. The number of women with positive screening results was 8,984, and the positive rate was 5.99%. 799 were diagnosed as precancerous lesions, and the detection rate was 532.96/105. 41 were diagnosed as invasive cervical cancer, and the detection rate was 27. 35/105. Among them,9 cases were diagnosed as early cervical cancer, and the early diagnosis rate was 96. 19%. The comparison of two different screening methods showed that the positive rate, the detection rate of low-grade squamous intraepithelial lesions, the detection rate of high-grade squamous intraepithelial lesions, and the detection rate of cervical precancerous lesions of HPV test were higher than those of cervical cytology(10.13% vs 3. 04%, 713. 41/105 vs 609. 83/105, 675. 02/105 vs 424. 48/105, and 679. 82/105 vs 427. 91/105, respectively), and the differences between the two screening methods were statistically significant(P< 0. 05). Conclusion The effect of cervical cancer screening in rural areas of Dalian from 2014 to 2019 is obvious. Compared with cervical cytology test, cervical cancer screening strategy based on HPV test as the primary screening method can better detect cervical precancerous lesions and facilitate earlier follow-up management. Each district and county should make a scientific, efficient and feasible cervical cancer screening program strategy according to the local actual situation.
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Keywords:
- rural women /
- cervical cancer /
- screening
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[1] Arbyn M,CastellsaguéX,de SanjoséS,et al.Worldwide burden of cervical cancer in 2008[J].Ann Oncol,2011,22(12):2675-2686.
[2] Parkin DM,FI Bray,SS Devesa.Cancer burden in the year 2000.The global picture[J].Eur J Cancer,2001,37(Suppl 8):S4-66.
[3] Arbyn M,Weiderpass E,Bruni L,et al.Estimates of incidence and mortality of cervical cancer in 2018:a worldwide analysis[J].Lancet Glob Health,2020,8(2):e191-e203.
[4] Bo Zhu,Yunyong Liu,Tingting Zuo,et al.The prevalence,trends,and geographical distribution of human papillomavirus infection in China:The pooled analysis of 1.7 million women[J].Cancer Med,2019,8(11):5373-5385.
[5] Van Dyne EA,Henley SJ,Saraiya M,et al.Trends in Human Papillomavirus-Associated Cancers-United States,1999-2015[J].MMWR Morb Mortal Wkly Rep,2018,67(33):918-924.
[6] Hansen BT,S Campbell,M Nygard.Long-term incidence trends of HPV-related cancers,and cases preventable by HPV vaccination:a registry-based study in Norway[J].BMJ Open,2018,8(2):e019005.
[7] WHO.Global strategy to accelerate the elimination of cervical cancer as a public health problem,Geneva 17November 2020.
[8] 任文辉,赵艳霞,马兰,等.我国贫困地区宫颈癌筛查效果及影响因素研究[J].中国妇产科临床杂志,2020,21(04):388-391. [9] 魏丽慧,吴久玲.子宫颈癌检查质量保障及质量控制指南[M].北京:人民卫生出版社,2015. [10] 刘广美,王奇娟,王奎香,等.北京市大兴区2013-2019年妇女宫颈癌和乳腺癌筛查结果分析[J].中国现代医药杂志,2020,22(07):39-43. [11] 赵淑芬.2016年葫芦岛市农村妇女宫颈癌筛查结果分析[J].航空航天医学杂志,2017,28 (10):1183-1184. [12] Harriet D Gliddon,Rosanna W Peeling,Mary L Kamb,et al.A systematic review and meta-analysis of studies evaluating the performance and operational characteristics of dual point-of-care tests for HIV and syphilis[J].Sex Transm Infect,2017,93(S4):S3-S15.
[13] 徐晓辉,白淑娟,王志红,等.河南省农村妇女宫颈癌筛查中不同筛查方法效果评价[J].肿瘤基础与临床,2020,33(02):148-153. [14] Nicole G Campos,Jose Jeronimo,Vivien Tsu,et al.The Cost-Effectiveness of Visual Triage of Human Papillomavirus-Positive Women in Three Low-and Middle-Income Countries[J].Cancer Epidemiol Biomarkers Prev,2017,26(10):1500-1510.
[15] 臧元怡.高危HPV检测联合TCT在宫颈癌筛查中的应用[J].现代中西医结合杂志,2015,24 (11):1184-1186. [16] 沈洁,高丽丽,张月,等.北京35-64岁妇女不同模式免费宫颈癌筛查结果分析[J].中国公共卫生,2018,34(7):942-945 [17] Yang A,E Farmer TC Wu,CF Hung.Perspectives for therapeutic HPV vaccine development[J].J Biomed Sci,2016,23(1):75.
[18] 郑国华,代云,蒋丽,等.宫颈液基薄层细胞学检测技术联合阴道镜在宫颈癌前病变筛查中的应用价值[J].河北医药,2017,39(4):524-527. [19] 温绍云,黄敏.分析宫颈液基细胞学检查(TCT)联合HPV筛查癌前期病变和早期宫颈癌的临床价值[J].智慧健康,2020,6(18):12-13,16. [20] 钟兴明,杜明娣,荆春霞,等.高危型HPV持续感染与宫颈癌前病变的相关性[J].中国热带医学,2018,18(03):267-270. [21] 朱晓华,张晓兰,卢锦,等.高危型人乳头状瘤病毒配合液基薄层细胞学检查在宫颈癌早期癌前病变筛查中的应用价值分析[J].中国卫生检验杂志,2019,29(12):1502-1505. [22] Zhao F,Qiao Y.Cervical cancer prevention in China:a key to cancer control[J].Lancet,2019,393(10175):969-970.
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