Benard Vicki B, Thomas Cheryll C, King Jessica, Massetti Greta M, Doria-Rose V Paul, Saraiya Mona
MMWR Morb Mortal Wkly Rep. 2014 Nov 7;63(44):1004-9.
Cervical cancer screening is one of the greatest cancer prevention achievements, yet some women still develop or die from this disease.
To assess recent trends in cervical cancer incidence and mortality, current screening percentages, and factors associated with higher incidence and death rates and inadequate screening.
Percentages of women who had not been screened for cervical cancer in the past 5 years were estimated using data from the 2012 Behavioral Risk Factor Surveillance System survey. State-specific cervical cancer incidence data from the United States Cancer Statistics and mortality data from the National Vital Statistics System were used to calculate incidence and death rates for 2011 by state. Incidence and death rates and annual percentage changes from 2007 to 2011 were calculated by state and U.S. Census region.
In 2012, the percentage of women who had not been screened for cervical cancer in the past 5 years was estimated to be 11.4%; the percentage was larger for women without health insurance (23.1%) and for those without a regular health care provider (25.5%). From 2007 to 2011, the cervical cancer incidence rate decreased by 1.9% per year while the death rate remained stable. The South had the highest incidence rate (8.5 per 100,000), death rate (2.7 per 100,000), and percentage of women who had not been screened in the past 5 years (12.3%).
Trends in cervical cancer incidence rates have decreased slightly while death rates have been stable over the last 5 years. The proportion of inadequately screened women is higher among older women, Asians/Pacific Islanders, and American Indians/Alaska Natives.
There continue to be women who are not screened as recommended, and women who die from this preventable cancer. Evidence-based public health approaches are available to increase women's access to screening and timely follow-up of abnormal results.
宫颈癌筛查是癌症预防领域最伟大的成就之一，但仍有一些女性患上这种疾病或因此死亡。
评估宫颈癌发病率和死亡率的近期趋势、当前筛查比例，以及与较高发病率、死亡率和筛查不足相关的因素。
利用2012年行为危险因素监测系统调查的数据，估算过去5年未进行宫颈癌筛查的女性比例。使用美国癌症统计中的特定州宫颈癌发病率数据和国家生命统计系统中的死亡率数据，计算2011年各州的发病率和死亡率。按州和美国人口普查区域计算2007年至2011年的发病率、死亡率及年度百分比变化。
2012年，估计过去5年未进行宫颈癌筛查的女性比例为11.4%；没有医疗保险的女性（23.1%）和没有固定医疗服务提供者的女性（25.5%）这一比例更高。2007年至2011年，宫颈癌发病率每年下降1.9%，而死亡率保持稳定。南部地区的发病率最高（每10万人中有8.5例）、死亡率最高（每10万人中有2.7例），且过去5年未接受筛查的女性比例最高（12.3%）。
过去5年宫颈癌发病率呈轻微下降趋势，而死亡率保持稳定。在老年女性、亚裔/太平洋岛民和美国印第安人/阿拉斯加原住民中，筛查不足的女性比例较高。
仍有女性未按建议进行筛查，也有女性死于这种可预防的癌症。现已有基于证据的公共卫生方法，可增加女性接受筛查的机会，并对异常结果进行及时随访。
