Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel,
Arch Gynecol Obstet. 2014 Mar;289(3):615-22. doi: 10.1007/s00404-013-3045-z. Epub 2013 Oct 2.
This study describes the distribution and the trends of cervical abnormalities in Israel, based on Pap smear results.
A retrospective analysis of cervical smears received by the Central Pathology Laboratory of Maccabi Healthcare Services between January 2005 and December 2010.
In total, 711,541 Pap smears were screened in the study period. Cytological abnormalities were observed in 4.78% of the total smears screened. An increase was observed in the rate of positive results from 2.63% in 2005 to 6.78% in 2010 (p = 0.0026). The cervical abnormalities in the study period distributed as follows: atypical squamous cell (ASC)-2.72%, low-grade squamous intraepithelial lesion (LSIL)-1.54%, high-grade squamous intraepithelial lesion (HSIL)-0.34%, squamous cell carcinoma-0.01%, atypical glandular cells (AGC)-0.10%, adenocarcinoma in situ (AIS)-0.06% and invasive adenocarcinoma-0.01%. The increase was statistically significant for ASC (p = 0.0028), LSIL (p = 0.0069) and for HSIL (p = 0.0260). The mean ages at diagnosis of women with ASCUS, LSIL, HSIL, squamous cell carcinoma, AGC, AIS and adenocarcinoma were 37.8, 33.2, 38.6, 55.4, 41.1, 49.9 and 57.1 years, respectively.
The increase in the rate of squamous cell abnormalities demonstrated in this study emphasizes the need of implementing an education and a screening program among Israeli women. HPV vaccine, sexual behavior, cytology performance and HPV test are primary and secondary prevention tools which may reduce morbidity and mortality in the future. In addition, based on the age at diagnosis of the different pathologies, the age group in which Pap test is performed in Israel should be expanded from 35-54 to 25-65 years.
本研究基于巴氏涂片结果，描述了以色列宫颈异常的分布和趋势。
对 2005 年 1 月至 2010 年 12 月期间 Maccabi 医疗保健服务中心收到的中央病理学实验室的宫颈涂片进行回顾性分析。
在研究期间，共筛查了 711541 例巴氏涂片。在筛查的总涂片中有 4.78%观察到细胞学异常。阳性结果的比例从 2005 年的 2.63%上升到 2010 年的 6.78%（p = 0.0026）。研究期间的宫颈异常分布如下：非典型鳞状细胞（ASC）-2.72%，低度鳞状上皮内病变（LSIL）-1.54%，高度鳞状上皮内病变（HSIL）-0.34%，鳞状细胞癌-0.01%，非典型腺细胞（AGC）-0.10%，原位腺癌（AIS）-0.06%和浸润性腺癌-0.01%。ASC（p = 0.0028）、LSIL（p = 0.0069）和 HSIL（p = 0.0260）的增加具有统计学意义。ASCUS、LSIL、HSIL、鳞状细胞癌、AGC、AIS 和腺癌患者的平均诊断年龄分别为 37.8、33.2、38.6、55.4、41.1、49.9 和 57.1 岁。
本研究中显示的鳞状细胞异常率的增加强调了在以色列妇女中实施教育和筛查计划的必要性。HPV 疫苗、性行为、细胞学表现和 HPV 检测是初级和二级预防工具，可能会降低未来的发病率和死亡率。此外，基于不同病理学的诊断年龄，以色列进行巴氏涂片检查的年龄组应从 35-54 岁扩大到 25-65 岁。
