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[2012 - 2013年中国全国农村宫颈癌筛查项目报告数据分析]

[Analysis of the reported data of national rural cervical cancer screening project from 2012 to 2013, China].

作者信息

Luo X M, Song L, Wu J L, Liu Y, Di J L, Song B, Zheng R M, Ma L

机构信息

National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing 100013, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2016 Apr;50(4):346-50. doi: 10.3760/cma.j.issn.0253-9624.2016.04.012.

Abstract

OBJECTIVE

To analyze the reported data of national rural cervical cancer screening project from 2012 to 2013 and to evaluate the project implementation condition.

METHODS

Data of the national breast carcinoma and cervical cancer (two-cancer) screening project for rural women were collected from the online report system of key women and children's public health service programs.The screening items included: preliminary screening of cervical lesions (cervical cytology, using Traian Bethesda System(TBS) or Pap grading for classification and reporting), acetate/iodide staining (VIA/VILI), colposcopy, histopathological examination, and pathological diagnosis. The study collected the quarterly reported data from 1 183 counties of 30 provinces in 2014 and 1 130 counties of 30 provinces in 2013. Chi-square test was used to test the difference of positive detection rate, as well as precancerous cervical lesions, and cervical cancer detection rates among difference preliminary screening methods in 2012 and 2013.

RESULTS

In 2012 and 2013, the number of cervical cancer screening was 10 621 482 and 10 321 835. The percentage of using ThinPrep cytological test as the screening method was 77.17% (n=8 196 627) and 77.07% (n=7 954 949) in 2012 and 2013, respectively. Among these ThinPrep cytological tests in these two years, 65.49% (n=5 368 194) and 71.67% (n=5 701 033) used TBS report system. The abnormality rate of colposcopy increased from 27.29% (170 063/623 161) to 31.15% (203 397/652 935) (χ(2)=2 295.94,P<0.001). The abnormality rate of histopathology test increased from 19.54% (37 992/194 394) to 35.43% (59 004/166 518) (χ(2)=11 523.58, P<0.001). All together, 27 341 cervical cancer or precancerous lesions have been detected in these two years. The detection rate of invasive cervical cancer increased from 18.02/100 000 in 2012 to 19.71/100 000 (χ(2)=7.90,P=0.005) in 2013 and that of precancerous lesions rose from 106.85/100 000 to 119.26/100 000 (χ(2)=70.82,P<0.001). The early detection rate was 89.60% (11 883/13 263), and 89.57% (12 609/14 078), respectively in 2012 and 2013. In these two years, the rank of the detection rate of each cervical lesion were CIN1, CIN2, CIN3, invasive carcinoma, adenocarcinoma in situ, and microinvasive carcinoma, from the highest rate to the lowest rate.

CONCLUSION

The program has achieved certain screening effect and the screening method has been improved. However, the quality of colposcope and histopathology should be enhanced.

摘要

目的

分析2012 - 2013年全国农村宫颈癌筛查项目上报数据,评估项目实施情况。

方法

从妇幼重大公共卫生服务项目网络直报系统收集全国农村妇女乳腺癌和宫颈癌(两癌)筛查项目数据。筛查项目包括:宫颈病变初筛(宫颈细胞学检查,采用特拉维夫贝塞斯达系统(TBS)或巴氏分级进行分类和报告)、醋酸/碘染色(VIA/VILI)、阴道镜检查、组织病理学检查及病理诊断。本研究收集了2014年30个省1183个县及2013年30个省1130个县的季度上报数据。采用卡方检验比较2012年和2013年不同初筛方法中阳性检出率、宫颈癌前病变及宫颈癌检出率的差异。

结果

2012年和2013年宫颈癌筛查人数分别为10621482人和10321835人。2012年和2013年采用薄层液基细胞学检测作为筛查方法的比例分别为77.17%(n = 8196627)和77.07%(n = 7954949)。在这两年的薄层液基细胞学检测中,分别有65.49%(n = 5368194)和71.67%(n = 5701033)采用TBS报告系统。阴道镜检查异常率从27.29%(170063/623161)升至31.15%(203397/652935)(χ(2)=2295.94,P<0.001)。组织病理学检查异常率从19.54%(37992/194394)升至35.43%(59004/166518)(χ(2)=11523.58,P<0.001)。这两年共检出宫颈癌及癌前病变27341例。浸润性宫颈癌检出率从2012年的18.02/10万升至2013年的19.71/10万(χ(2)=7.90,P = 0.005),癌前病变检出率从106.85/10万升至119.26/10万(χ(2)=70.82,P<0.001)。2012年和2013年早期检出率分别为89.60%(11883/13263)和89.57%(12609/14078)。这两年中,各宫颈病变检出率从高到低依次为CIN1、CIN2、CIN3、浸润癌、原位腺癌、微浸润癌。

结论

该项目取得了一定的筛查效果,筛查方法有所改进。但阴道镜及组织病理学检查质量有待提高。

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