Elliott P M, Tattersall M H, Coppleson M, Russell P, Wong F, Coates A S, Solomon H J, Bannatyne P M, Atkinson K H, Murray J C
Gynaecological Oncology Unit, King George V Memorial Hospital, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
BMJ. 1989 Feb 4;298(6669):288-90. doi: 10.1136/bmj.298.6669.288.
To examine the hypothesis that the pattern of cervical cancer is changing data on women presenting with the disease over 34 years were studied retrospectively. During 1953-86, 2628 women with cervical cancer were referred to a large tertiary referral hospital in Sydney; 418 were aged 35 or less. During the period of review the proportion of young women with the disease increased from under 9% in the 1950s and 1960s to about 25% in the 1970s and 1980s; a similar but less pronounced trend was apparent for the whole of New South Wales in the 1970s and 1980s. The prevalence of less common morphological types of cervical cancer increased throughout the period, particularly in the young. Pelvic lymph node metastases were identified in younger patients with stage Ib and IIa tumours more commonly in the later years of the study, suggesting that the disease was becoming more severe. Overall rates of recurrence improved over time, but an apparent increase in early recurrences was observed in young patients with Ib and IIa tumours and without nodal disease. The results suggest that the clinical and pathological behaviour of cervical cancer changed over the period of review.
为检验宫颈癌模式正在发生变化这一假设，我们对34年间患该疾病女性的数据进行了回顾性研究。1953年至1986年期间，2628例宫颈癌女性被转诊至悉尼一家大型三级转诊医院；其中418例年龄在35岁及以下。在审查期间，患该疾病的年轻女性比例从20世纪50年代和60年代的不到9%增至20世纪70年代和80年代的约25%；20世纪70年代和80年代，新南威尔士州整体也出现了类似但不太明显的趋势。在整个时期，宫颈癌较不常见形态类型的患病率均有所上升，在年轻患者中尤为明显。在研究后期，Ib期和IIa期肿瘤的年轻患者中更常见盆腔淋巴结转移，这表明疾病正变得更加严重。总体复发率随时间有所改善，但在Ib期和IIa期肿瘤且无淋巴结疾病的年轻患者中，早期复发明显增加。结果表明，在审查期间宫颈癌的临床和病理行为发生了变化。
