Hoffman M, Cooper D, Carrara H, Rosenberg L, Kelly J, Stander I, Williamson A-L, Denny L, du Toit G, Shapiro S
Department of Public Health and Primary Health Care, University of Cape Town, South Africa.
Int J Epidemiol. 2003 Aug;32(4):573-7. doi: 10.1093/ije/dyg081.
We investigated the effect of Pap smear screening on the incidence of invasive cancer of the cervix in the Western Cape, South Africa where screening is limited.
Data were derived from a case-control study of the association of hormonal contraceptives and invasive cervical cancer. Incident cases (n = 524) of invasive cervical cancer who presented at two tertiary hospitals and controls (n = 1540) series matched for age, race, and place of residence were interviewed. Information on a wide range of variables was collected including whether the women had previously had a Pap smear taken and the number and timing of smears. Odds ratios (OR) and 95% CI were calculated using multiple logistic regression.
The OR of cervical cancer was reduced among women who had ever had a smear (OR = 0.3, 95% CI: 0.3-0.4). The OR declined with increasing number of smears to 0.2 for >/=>3 smears (trend P = 0.0003). Among women who had a smear <5 years previously the OR was 0.3, but even if the smear was taken >/=15 years previously the women remained at reduced risk (OR = 0.5).
The data suggest that even limited Pap smear screening reduces the risk of cervical cancer. Should a screening programme be successfully implemented, the incidence of cervical cancer might be reduced by as much as 70%.
我们在南非西开普省对子宫颈抹片检查对浸润性宫颈癌发病率的影响进行了调查，该地区的筛查工作有限。
数据来源于一项关于激素避孕药与浸润性宫颈癌关联的病例对照研究。对在两家三级医院就诊的浸润性宫颈癌的发病病例（n = 524）以及按年龄、种族和居住地点匹配的对照组（n = 1540）进行了访谈。收集了一系列变量的信息，包括这些女性之前是否做过子宫颈抹片检查以及抹片检查的次数和时间。使用多元逻辑回归计算比值比（OR）和95%置信区间（CI）。
曾经做过抹片检查的女性患宫颈癌的OR降低（OR = 0.3，95% CI：0.3 - 0.4）。随着抹片检查次数的增加，OR下降，对于≥3次抹片检查，OR降至0.2（趋势P = 0.0003）。在5年内做过抹片检查的女性中，OR为0.3，但即使抹片检查是在≥15年前进行的，这些女性的风险仍然降低（OR = 0.5）。
数据表明，即使是有限的子宫颈抹片检查也能降低患宫颈癌的风险。如果筛查计划成功实施，宫颈癌的发病率可能会降低多达70%。
