Lewis Hazel, Yeh Li-Chia, Almendral Bobby, Neal Harold
National Screening Unit, Ministry of Health, P O Box 5013, Wellington, New Zealand.
N Z Med J. 2009 Oct 30;122(1305):15-25.
To describe the method developed by the National Cervical Screening Programme (NCSP) for review of cases of cervical cancer; present results from the first 4 years of the review and compare these results with those of the earlier New Zealand Cervical Cancer Audit.
Linkage of cervical cancer registrations from the New Zealand Cancer Registry to smear histories from the NCSP Register via the National Health Index, for the 4-year period 2003-06.
A total of 625 women were registered with cervical cancer from 2003-06, of whom 438 were eligible for linkage (women diagnosed with squamous or adenosquamous cervical cancer at <80 years of age). Of these 438 eligible cases, 348 were histologically invasive and 90 were microinvasive. Unlike histological stage, clinical FIGO stage was missing in approximately 50%. Linkage to screening history revealed that 202 of the 438 eligible women (46%) had never been enrolled in the NCSP; 137 (31%) were enrolled but had only been infrequently or irregularly screened; and 85 (20%) developed cancer despite regular screening (data were missing for 3 women). These results were similar to those found in the New Zealand Cervical Cancer Audit, covering the period 2000-2002.
Ongoing linkage of cancer data to screening data can be used to monitor the performance of the NCSP. Our finding that 80% of potentially preventable cervical cancers involve women who are not enrolled in the Programme or who have been only infrequently and irregularly screened, confirms that improving Programme coverage (currently around 72%) remains a priority. Further investigation (phase 2) is required for the small number of women who develop cervical cancer despite regular screening (average of 21 per year, or approximately 20% of eligible cases), to distinguish interval cancers from possible Programme quality issues.
描述国家宫颈癌筛查计划（NCSP）所制定的宫颈癌病例审查方法；呈现审查头4年的结果，并将这些结果与早期新西兰宫颈癌审计结果进行比较。
在2003 - 2006年的4年期间，通过国家健康指数将新西兰癌症登记处的宫颈癌登记信息与NCSP登记处的涂片病史进行关联。
2003 - 2006年共有625名女性登记患有宫颈癌，其中438名符合关联条件（年龄小于80岁、被诊断为鳞状或腺鳞癌的女性）。在这438例符合条件的病例中，348例为组织学浸润性癌，90例为微浸润癌。与组织学分期不同，约50%的病例缺少临床国际妇产科联盟（FIGO）分期。与筛查病史的关联显示，438例符合条件的女性中，202例（46%）从未参加过NCSP；137例（31%）已登记，但筛查频率低或不规律；85例（20%）尽管定期筛查仍患癌（3名女性数据缺失）。这些结果与2元000 - 2002年期间新西兰宫颈癌审计的结果相似。
癌症数据与筛查数据的持续关联可用于监测NCSP的绩效。我们发现80%的潜在可预防宫颈癌涉及未参加该计划或筛查频率低且不规律的女性，这证实提高计划覆盖率（目前约为72%）仍然是优先事项。对于少数尽管定期筛查仍患宫颈癌的女性（平均每年21例，约占符合条件病例的20%），需要进一步调查（第二阶段），以区分间隔期癌症与可能的计划质量问题。
