如皋市116 715例适龄妇女宫颈癌筛查结果分析及筛查策略研究
Analysis of cervical cancer screening results and screening strategy of 116 715 women of appropriate age in Rugao City
朱继华1
作者信息
- 1. 如皋市妇幼保健计划生育服务中心 妇女保健科,江苏 南通 226500
- 折叠
摘要
目的 对35～64岁适龄妇女宫颈癌筛查结果进行分析,探讨不同筛查模式在宫颈癌筛查中的应用价值.方法 选择116 715例宫颈癌筛查的适龄妇女为研究对象,其中TCT初筛57 780例,HPV初筛58 935例.对后续检查的随访情况、指标完成情况进行评价,并对比TCT初筛、HPV初筛宫颈癌阳性、阴道镜检查、宫颈病理学检查结果及宫颈病变随访治疗情况.结果 初筛宫颈癌总体阴道镜随访率、宫颈组织病理学随访率分别为96.68％、99.53％,HPV初筛阴道镜随访率、宫颈组织病理学随访率分别为97.55％、99.76％,TCT初筛阴道镜随访率、宫颈组织病理学随访率分别为95.74％、99.23％,HPV初筛阴道镜随访率、宫颈组织病理学随访率均高于TCT初筛,差异有统计学意义(P＜0.05);HPV初筛阳性率、阴道镜异常检出率分别为12.72％、79.99％,TCT初筛阳性率、阴道镜异常检出率分别为4.02％、71.93％,HPV初筛阳性率、阴道镜异常检出率均高于TCT初筛,差异有统计学意义(P＜0.05);总体宫颈癌前病变检出率、宫颈癌检出率、早诊率分别为500.36/10万、53.12/10万、91.24％,HPV初筛宫颈癌前病变检出率为605.75/10万,TCT初筛宫颈癌前病变检出率392.87/10万,HPV初筛宫颈癌前病变检出率高于TCT初筛,差异有统计学意义(P＜0.05);HPV初筛宫颈癌检出率、早诊率分别62.78/10万、91.75％,TCT初筛宫颈癌检出率、早诊率分别为43.27/10万、90.62％,HPV初筛与TCT初筛宫颈癌检出率、早诊率比较差异均无统计学意义(P＞0.05);宫颈病变随访治疗率为97.28％,达到项目≥95％的指标要求.结论 如皋市35～64岁妇女"两癌"筛查工作取得了一定的成效,但在阳性病例后续管理仍有缺口,需采取分层次的宣教模式做好健康宣教,提高参检妇女主动配合后续管理的意识.HPV初筛筛查模式符合如皋市实际且行之有效.
Abstract
Objective To analyze the results of cervical cancer screening in women aged 35～64 and explore the application value of different screening modes in cervical cancer screening.Methods A total of 116 715 women of appropriate age for cervical cancer screening were selected as subjects,including 57 780 for TCT screening and 58 935 for HPV screening.The follow-up of follow-up examination and the completion of indicators were evaluated,and the positive results of TCT preliminary screening,HPV preliminary screening,colposcopy,cervical pathology examination and follow-up treatment of cervical lesions were compared.Results The overall colposcopy follow-up rate and cervical histopathology follow-up rate were 96.68％and 99.53％,respectively,the colposcopy follow-up rate and cervical histopathology follow-up rate of HPV preliminary screening were 97.55％and 99.76％,respectively.The follow-up rates of colposcopy and cervical histopathology were 95.74％and 99.23％,respectively.The follow-up rates of colposcopy and cervical histopathology were higher than those of TCT,and the difference was statistically significant(P＜0.05).HPV preliminary screening positive rate and colposcopy abnormal detection rate were 12.72％and 79.99％,respectively.TCT preliminary screening positive rate and colposcopy abnormal detection rate were 4.02％and 71.93％,respectively.HPV preliminary screening positive rate and colposcopy abnormal detection rate were higher than TCT preliminary screening,the difference was statistically significant(P＜0.05).The overall detection rate of precancerous lesions,cervical cancer detection rate and early diagnosis rate were 500.36/100 000,53.12/100 000 and 91.24％,respectively.The detection rate of precancerous lesions was 605.75/100 000 for HPV preliminary screening and 392.87/100 000 for TCT preliminary screening.The detection rate of cervical precancerous lesions in HPV screening was higher than that in TCT screening,the difference was statistically significant(P＜0.05).The cervical cancer detection rate and early diagnosis rate of HPV preliminary screening were 62.78/100 000 and 91.75％,respectively;the cervical cancer detection rate and early diagnosis rate of TCT preliminary screening were 43.27/100 000 and 90.62％,respectively.There was no statistical significance between HPV preliminary screening and TCT preliminary screening(P＞0.05).The follow-up treatment rate of cervical lesions was 97.28％,which met the target requirements of the project ≥95％.Conclusion The screening work of"two cancers"among women aged 35-64 in Rugao city has achieved certain results,but there is still a gap in the follow-up management of positive cases.It is necessary to adopt a hierarchical education model to do a good job in health education and improve the awareness of participating women to actively cooperate with follow-up management.HPV preliminary screening mode is practical and effective in Rugao City.
关键词
宫颈癌/TCT初筛/HPV初筛/宫颈癌前病变Key words
Cervical cancer/TCT preliminary screening/HPV primary screening/Precancerous lesions of cervical cancer引用本文复制引用
出版年
2024
NETL
NSTL
万方数据