2015—2019年安徽省农村妇女宫颈癌筛查结果分析

目的 通过分析2015—2019年安徽省农村妇女宫颈癌筛查结果，为进一步推动宫颈癌防治工作提供参考依据。方法 数据来自于国家妇幼重大公共卫生服务项目信息直报系统。采用宫颈细胞学检查、醋酸染色/复方碘染色检查（偏远地区）、试点地区HPV筛查，阴道镜和病理活检方法。结果 组织病理学活检后确诊宫颈癌前病变9 314例，宫颈癌447例，宫颈癌前病变检出率350.43/10万，χ2线性趋势检验差异有统计学意义（χ2 = 17.49，P＜0.05）。宫颈癌检出率为16.82/10万，各年度宫颈癌检出率差异无统计学意义（χ2 = 2.15，P＞0.05），各年度早诊率差异无统计学意义（χ2 = 1.74，P＞0.05）。宫颈细胞学筛查与HPV检测方法比较宫颈癌前病变差异有统计学意义（χ2 = 312.10，P＜0.05）。结论 安徽省农村妇女宫颈癌前病变检出率和早诊率较高，治疗比例相对较低，部分县区检出率差异大，检出例数排名前十的县区，检出率除阜南县外基本均高于全省平均水平，服务质量和宫颈早期病变的干预力度有待加强，应进一步提高医疗机构的服务能力，巩固农村妇女宫颈癌检查项目筛查效果。

Analysis of cervical cancer screening results of rural women in Anhui Province from 2015 to 2019

To provide a reference basis for further promoting cervical cancer prevention and treatment by analyzing the results of cervical cancer screening among rural women in Anhui Province from 2015 to 2019. Methods Data were obtained from the national maternal and child major public health service project information direct reporting system. Cervical cytology,acetic acid staining/recombined iodine staining(remote areas), HPV screening in pilot areas, colposcopy and pathological biopsy methods were used. Results Histopathological biopsies confirmed 9 314 cases of cervical precancerous lesions and 447 cases of cervical cancer, with a cervical precancerous lesion detection rate of 350.43/100 000 and a statistically significant difference by χ2 linear trend test(χ2= 17.49, P<0.05). The cervical cancer detection rate was 16.82/100 000, with no statistically significant difference in cervical cancer detection rate by year(χ2=2.15, P>0.05) and no statistically significant difference in early diagnosis rate by year(χ2=1.74, P >0.05). There was a statistically significant difference between cervical cytological screening and HPV detection methods compared with cervical precancerous lesions(χ2=312.10, P <0.05). Conclusion The detection rate and early diagnosis rate of cervical precancerous lesions among rural women in Anhui Province are high, the treatment ratio is relatively low, the detection rate varies greatly in some counties, and the detection rate of the top ten counties in terms of the number of detected cases is basically higher than the provincial average except for Funan County. The service quality and intervention of early cervical lesions need to be strengthened, and the service capacity of medical institutions should be further improved to consolidate the screening effectiveness of cervical cancer screening program for rural women.