Marquardt K, Stubbe M, Broschewitz U
Praxis für Pathologie, Güstrower Str. 34, 19055, Schwerin, Deutschland.
Praxis für Pathologie, Rostock, Deutschland.
Pathologe. 2016 Feb;37(1):78-83. doi: 10.1007/s00292-015-0120-1.
In view of the discussion on primary human papillomavirus (HPV) screening it was necessary to evaluate recent and reliable data from the current cytology-based screening program.
Since the year 2004 all cases of cervical cancer must be reported to the Joint State Quality Control Commission in Mecklenburg-Western Pomerania, corrected and supplemented by data of the State Cancer Registry. The screening histories of all patients, age, tumor stages and histological tumor types were analyzed.
Over a 10-year period (2004-2013) 985 women with invasive cervical cancer and complete data were identified, of whom 573 patients (58 %) had not had a cervical smear within the past 5 years, an irregular screening history was found in 312 patients (32 %) and 100 patients (10 %) had cervical cancer despite regular participation. In women who did not participate in the screening program, tumor stages T1b and higher were found in 85 %. In the group of women with regular screening 53 % were diagnosed with microinvasive cancer and in 38 % of women with irregular screening. The age distribution showed a peak for cervical cancer in the age group of 40-54 years. Squamous cell carcinoma dominated and adenocarcinoma was found in 17 % which showed a tendency to increase over the investigation time period.
Most cervical cancers and the advanced stages were found in women who did not participate in the screening program.
鉴于关于原发性人乳头瘤病毒（HPV）筛查的讨论，有必要评估当前基于细胞学的筛查项目的最新可靠数据。
自2004年起，所有宫颈癌病例必须上报至梅克伦堡-前波美拉尼亚州联合国家质量控制委员会，并由国家癌症登记处的数据进行校正和补充。分析了所有患者的筛查史、年龄、肿瘤分期和组织学肿瘤类型。
在10年期间（2004 - 2013年），共确定了985例患有浸润性宫颈癌且数据完整的女性，其中573例患者（58%）在过去5年内未进行过宫颈涂片检查，312例患者（32%）筛查史不规律，100例患者（10%）尽管定期参与筛查仍患宫颈癌。未参加筛查项目的女性中，85%的肿瘤分期为T1b及以上。在定期筛查的女性组中，53%被诊断为微浸润癌，在筛查不规律的女性组中这一比例为38%。年龄分布显示，宫颈癌在40 - 54岁年龄组出现一个高峰。鳞状细胞癌占主导，腺癌占17%，且在调查期间有增加趋势。
大多数宫颈癌及晚期病例发现于未参加筛查项目的女性中。
