2014 - 2018年海南省基于细胞学初筛农村妇女宫颈癌结果分析

目的 了解海南省2014 - 2018年农村妇女宫颈癌发生情况，为宫颈癌的防治提供依据。方法 依据国家统一制定的项目技术方案，对项目县35～64岁农村妇女进行宫颈癌检查，采用描述性分析和χ2检验分析检查结果。结果 2014 - 2018年共检查40.32万名农村妇女，任务完成率为107.54%。其中，宫颈细胞学检查阳性检出率为2.89%，不同年份检出率间存在统计学意义(χ2 = 163.493，P＜0.001)。阴道镜异常/可疑的检出率为33.48%，不同年份间阴道镜异常/可疑检出率存在统计学意义(χ2 = 225.68，P＜0.001)。宫颈病理异常/可疑的检出率为42.59%，不同年份间组织病理学异常/可疑检出率存在统计学意义(χ2 = 84.160，P＜0.001)，且呈现出逐年下降趋势（Z = 2.001，P = 0.048）。共检出异常个案1 659例，检出率为0.41%。宫颈癌前病变检出率为151.04/10万，宫颈癌检出率14.38/10万，宫颈癌及癌前病变检出率165.42/10万。早期诊断人数为632人，早诊率为94.75%。结论 海南省宫颈癌检查项目取得了一定的成效，仍需政府加大投入，加强阳性病例的管理，进一步提高基层医务人员的筛检水平，提高筛查效能。

Analysis of cervical cancer screening result of rural females in Hainan between 2014 and 2018

The aim of this study was to analyze the data of Hainan rural women’s cervical cancer screening project from 2014 to 2018 based on cytology, to understand the implementation of the project and the incidence of cervical diseases among rural women in the province, so as to provide a basis for the prevention and treatment of cervical cancer. Methods According to the national unified technical plan of the project, cervical cancer screening was carried out for rural women aged from 35 to 64 in the project counties, and the project implementation and cervical cancer screening results were retrospectively analyzed. Results A total of 403,200 rural women were examined from 2014 to 2018, with a completion rate of107.54 percent. The positive rate of cervical cytology was 2.89%, with statistical significance in different years(χ2=163.493,P<0.001). The detection rate of abnormal/suspicious colposcopies was 33.48%. There was statistical significance in different years(χ2=225.68, P<0.001). The detection rate of abnormal/suspicious pathology was 42.59%. The detection rate of abnormal/suspicious histopathology was statistically significant(χ2=84.160, P<0.001) in different years, and there was a trend change(Z=2.001, P=0.048). The detection rate of abnormal/suspicious pathology showed a downward trend year by year. A total of 1659 abnormal cases were detected, with a detection rate of 0.41%. The detection rate of cervical cancer precancerous lesions was151.04 per 100,000, cervical cancer 14.38 per 100,000, and cervical cancer and precancerous lesions 165.42 per 100,000.The number of early diagnosis was 632, and the early diagnosis rate was 94.75%. Conclusion The cervical cancer screening project in Hainan province achieved certain results, but the government still needs to increase investment, strengthen the management of positive cases, further improve the screening level of grassroots medical personnel, and improve the screening efficiency.