Law Irwin, Fong James J, Buadromo Eka M, Samuela Josaia, Patel Mahomed S, Garland Suzanne M, Mulholland E Kim, Russell Fiona M
National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT 0200, Australia.
Sex Health. 2013 May;10(2):171-8. doi: 10.1071/SH12135.
There are few population-based data on the disease burden of cervical cancer from developing countries, especially South Pacific islands. This study aimed to determine the incidence and mortality associated with cervical cancer and the coverage of Papanicolaou (Pap) cervical cytology in 20- to 69-year-old women in Fiji from 2004 to 2007.
National data on the incident cases of histologically confirmed cervical cancer and the associated deaths, and on Pap smear results were collected from all pathology laboratories, and cancer and death registries in Fiji from 2004 to 2007.
There were 413 incident cases of cervical cancer and 215 related deaths during the study timeframe. The annualised incidence and mortality rates in 20- to 69-year-old Melanesian Fijian women, at 49.7 per 100?000 (95% confidence interval (CI): 43.7-56.4) and 32.3 per 100?000 (95% CI: 26.9-38.4) respectively, were significantly higher than among 20- to 69-year-old Indo-Fijian women at 35.2 per 100?000 (P<0.001, 95% CI: 29.5-41.7) and 19.8 per 100?000 (P=0.002, 95% CI: 15.1-25.5) respectively. Of 330 cases diagnosed between 2004 and 2006, 186 (56%) had died by 31 December 2006. Pap smear coverage for this period was 8.0% (95% CI: 7.9-8.1) of the target population.
The incidence and mortality related to cervical cancer in Fiji is high, whereas Pap smear coverage is very low. Greater investment in alternative screening strategies and preventive measures should be integrated into a comprehensive, strategic cervical cancer control program in Fiji.
关于发展中国家，尤其是南太平洋岛屿宫颈癌疾病负担的基于人群的数据很少。本研究旨在确定2004年至2007年斐济20至69岁女性中与宫颈癌相关的发病率和死亡率以及巴氏宫颈细胞学检查的覆盖率。
收集了2004年至2007年斐济所有病理实验室、癌症和死亡登记处关于组织学确诊宫颈癌的发病病例及相关死亡情况以及巴氏涂片结果的全国数据。
在研究期间有413例宫颈癌发病病例和215例相关死亡。20至69岁的美拉尼西亚斐济女性的年化发病率和死亡率分别为每10万人口49.7例（95%置信区间（CI）：43.7 - 56.4）和每10万人口32.3例（95% CI：26.9 - 38.4），显著高于20至69岁的印度裔斐济女性，其发病率和死亡率分别为每10万人口35.2例（P < 0.001，95% CI：29.5 - 41.7）和每10万人口19.8例（P = 0.002，95% CI：15.1 - 25.5）。在2004年至2006年诊断的330例病例中，到2006年12月31日有186例（56%）死亡。该时期巴氏涂片检查的覆盖率为目标人群的8.0%（95% CI：7.9 - 8.1）。
斐济宫颈癌的发病率和死亡率很高，而巴氏涂片检查的覆盖率非常低。应将对替代筛查策略和预防措施的更多投资纳入斐济全面、战略性的宫颈癌控制计划中。
