2014-2019年大连市农村地区宫颈癌筛查数据分析

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149918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。

Analysis of cervical cancer screening results of rural women in Dalian City from 2014 to 2019

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 was532.96/105.41 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%vs3.04%,713.41/105 vs609.83/105,675.02/105 vs424.48/105,and 679.82/105 vs427.91/105,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.