子宫颈癌患者年轻化趋势的探讨

目的:了解不同时期广州地区子宫颈癌患者发病年龄、临床病理特征及其它相关危险因素的变化。方法:对中山大学肿瘤医院1985～1987年间(八十年代组)和1997～1999年间(九十年代组)收治的511例子宫颈癌进行回顾性分析,并按10岁的间隔进行年龄分组比较。结果:两组患者的平均年龄分别为56.6±10.8岁和45.0±12.3岁(P<0.001),年龄曲线随时间推移呈明显下降趋势。两组患者的宫颈癌组织学类型和分级及淋巴结转移情况无差别。但八十年代组多为较晚期肿瘤,Ⅲb期患者占22.2％;而九十年代组早期患者多,Ⅲb期患者仅占4.8％(P<0.05)。两组中老年患者较年轻患者妊娠和生育次数明显增多。结论:子宫颈癌患者年轻化的原因可能与一些社会因素,如开展宫颈疾病普查使宫颈癌得以早期诊断有关。人乳头状瘤病毒感染对宫颈癌年轻化的影响有待进一步研究。

Change in age at diagnosis of cervical cancer in Guangzhou over the past 15 years

Objective:To identify any significant changes in age at diagnosis and the clini-copathological or demographic characteristics of women diagnosed with cervical cancer in Guangzhou over the past 15 years. Methods: The clinicopathological and demographic features of 199 women with invasive cervical cancer diagnosed from 1985 to 1987 (group 1) were compared with those of 312 women diagnosed from 1997 to 1999 (group 2) in the Cancer Center of Sun Yat-sen University during the two time periods (N = 511) . The age groups were stratified into 10 year intervals between age < 40 years and > 60 years. Variables between both period groups and the different age groups were analysed using SPSS 9.0 software.Results:The mean age at diagnosis was 56.6 ±10.8 years in group 1 and 45,0 ± 12.3 years in group 2, respectively ( P < 0.001) . There was no significant difference between two groups in histological type and grade of cancers, and nodal status. However, group 1 presented significantly more advanced cancer cases than group 2, 22. 2% of patients in group 1 had stage IIIb disease,compared with only 4.8% in group 2 (P <0.05).The older patients in both groups had more pregnancies and births than younger patients ( P < 0.05 ) . Conclusions: The age at diagnosis of invasive cervical cancer in Guangzhou is falling, which may be related to that cervical cancers were detected and treated at an earlier stage in the late 1990s. A variety of social features, HPV infection and improvements to the screening programs for cervical cancer may be contributing to these changes.