Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Republic of Korea.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Republic of Korea.
J Geriatr Oncol. 2013 Oct;4(4):382-7. doi: 10.1016/j.jgo.2013.03.001. Epub 2013 Jun 14.
The purpose of this study was to evaluate the efficacy of cervical cancer screening (CCS) in Korean women over 65 years of age and to determine the age at which CCS becomes inefficacious, so that providers and policy makers can be more informed about when to stop screening.
The data of 999 women, who underwent CCS followed by colposcopy at the Korea University hospital from January 2007 to May 2012, were retrospectively evaluated. Age groups were classified as <21 (n=11), 21-29 (n=128), 30-65 (n=768), and >65 (n=92). To evaluate the value of CCS in women older than 65, age groups were simply divided into ≤ 65 or >65. Participants were also categorized into five strata of age groups (≤ 55 vs. >55, ≤ 60 vs. >60, ≤ 65 vs. >65, ≤ 70 vs. >70, and ≤ 75 vs. >75) that were compared to the sample to assess a cutoff-age at which to cease screening based on decreased efficacy.
The mean age was 45.5 ± 13.7 (range 14-80). There were no differences in the pathologic results for cervical intraepithelial neoplasia (CIN) values of < CIN2 vs. ≥ CIN2, or ≤ CIN3 vs. cancer among the groups. There was a significantly higher incidence of cancer compared with ≤ CIN3 in women aged >65 (13.0%) vs. ≤ 65 (6.6%), (p=0.037). To assess the cervical cancer incidence (CCI) from the larger number of cases by age, a prediction formula was calculated from a national dataset. CCI (per 100,000) continuously increased by age even for those in their 90 s.
CCS is still necessary in Korean women older than 65 since there is a substantial CCI rate occurring in these women. It is time to consider new guidelines that include the appropriate age and conditions for discontinuing screening.
本研究旨在评估韩国 65 岁以上女性进行宫颈癌筛查（CCS）的效果，并确定 CCS 无效的年龄，以便为提供者和政策制定者提供更准确的信息，了解何时停止筛查。
回顾性分析了 2007 年 1 月至 2012 年 5 月期间在韩国大学医院接受 CCS 并随后进行阴道镜检查的 999 名女性的资料。年龄组分为<21（n=11）、21-29（n=128）、30-65（n=768）和>65（n=92）。为了评估 65 岁以上女性 CCS 的价值，年龄组简单地分为≤65 或>65。还将参与者分为五个年龄组（≤55 岁 vs. >55 岁、≤60 岁 vs. >60 岁、≤65 岁 vs. >65 岁、≤70 岁 vs. >70 岁和≤75 岁 vs. >75 岁），与样本进行比较，以根据效果降低评估停止筛查的截止年龄。
平均年龄为 45.5±13.7（范围 14-80）。不同年龄组之间，宫颈上皮内瘤变（CIN）<CIN2 与≥CIN2 或<CIN3 与癌症的病理结果无差异。与≤CIN3 相比，年龄>65 岁的女性癌症发生率明显更高（13.0% vs. ≤65 岁，6.6%，p=0.037）。为了通过年龄评估更多病例的宫颈癌发病率（CCI），从全国数据集计算了预测公式。即使在 90 多岁的人群中，CCI（每 10 万人）也会随着年龄的增长而持续增加。
鉴于韩国 65 岁以上女性的 CCI 发生率较高，因此仍需要对其进行 CCS。现在是时候考虑包括适当年龄和停止筛查条件的新指南了。
