印度一项基于人群的女性常见癌症早期筛查项目——方法与中期结果

A population-based screening program for early detection of common cancers among women in India - methodology and interim results.

作者信息

Mishra G A, Dhivar H D, Gupta S D, Kulkarni S V, Shastri S S

机构信息

Department of Preventive Oncology, Tata Memorial Hospital, E. Borges Marg, Parel, Mumbai, Maharashtra, India.

出版信息

Indian J Cancer. 2015 Jan-Mar;52(1):139-45. doi: 10.4103/0019-509X.175581.

DOI:10.4103/0019-509X.175581

PMID:26838003

Abstract

BACKGROUND

Cancers of the uterine cervix, breast, and oral cavity accounted for 134,420, 115,251, and 24,375 cases, respectively, and were responsible for 52.8% of the total cancers among women in India in 2008.

AIM

The major objectives were to create awareness regarding common cancers among women, to detect pre-cancers of the uterine cervix and oral cavity, and early cancers of the breast, uterine cervix, and oral cavity, by conducting screening with simple, low-cost technology, within the community, and to facilitate confirmation of diagnosis among the screen positives and treatment and follow-up among the diagnosed cases.

SETTINGS AND METHODS

This is a community-based screening program for early detection of breast, uterine cervix, and oral cancers, being implemented among the socioeconomically disadvantaged women in Mumbai, India. The process involves selection of clusters, household surveys, health education, and screening the eligible women for breast, uterine cervix, and oral cancers, by primary healthcare workers, at a temporarily set-up clinic within the community. The program is planned to cover a 125,000 disadvantaged population in five years.

RESULTS

Twenty-one thousand and fifteen people, with 4009 eligible women, have been covered to date. The compliance for screening for breast, cervix, and oral cavity has been 85, 70, and 88% and the screen positivity rates are 3.9, 14.9, and 3.9%, respectively. Twenty-seven oral pre-cancers, 25 cervix pre-cancers, one invasive cancer of the breast, two of the cervix, and one oral cavity cancer have been diagnosed among the screened women and all of them have complied with the treatment.

CONCLUSIONS

The program is raising awareness about the common cancers and harms of tobacco among the disadvantaged women population in Mumbai. It is also helping in detecting pre-cancers and cancers among asymptomatic women and is assisting them in receiving treatment.

摘要

背景

2008年，子宫颈癌、乳腺癌和口腔癌病例分别为134420例、115251例和24375例，占印度女性癌症总数的52.8%。

目的

主要目标是通过在社区内采用简单、低成本技术进行筛查，提高女性对常见癌症的认识，检测子宫颈和口腔的癌前病变以及乳腺癌、子宫颈癌和口腔癌的早期癌症，并为筛查呈阳性者提供诊断确认，为确诊病例提供治疗和随访。

地点和方法

这是一项在印度孟买社会经济弱势女性中实施的基于社区的乳腺癌、子宫颈癌和口腔癌早期检测筛查项目。该过程包括选择群组、家庭调查、健康教育，以及由初级卫生保健人员在社区内临时设立的诊所对符合条件的女性进行乳腺癌、子宫颈癌和口腔癌筛查。该项目计划在五年内覆盖12.5万弱势人群。

结果

迄今为止，已覆盖21015人，其中4009名符合条件的女性。乳腺癌、子宫颈癌和口腔癌筛查的依从率分别为85%、70%和88%，筛查阳性率分别为3.9%、14.9%和3.9%。在接受筛查的女性中，已诊断出27例口腔癌前病变、25例子宫颈癌前病变、1例浸润性乳腺癌、2例子宫颈癌和1例口腔癌，所有患者均接受了治疗。