Preventive Medicine Center, International University of Health and Welfare, Mita Hospital, 1-4-3 Mita, Minato-Ku, Tokyo, Japan.
Saku Central Hospital Advanced Care Center, Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare, Nagano, Japan.
Int J Clin Oncol. 2022 Mar;27(3):473-480. doi: 10.1007/s10147-021-02100-w. Epub 2022 Jan 11.
Cervical cancer ranks high among the cancers that affect people in their 20s and 30s. Cervical cancer is characterized by the presence of precancerous lesions, which can be detected by cancer screenings; some precancerous lesions are amenable to treatment, which can halt the progression to invasive cancer. As a result, cervical cancer screening has been shown to reduce the incidence of invasive cancer and its mortality. On the other hand, many precancerous lesions do not progress to invasive cancer, but stagnate or disappear spontaneously. In Japan, there is a nationwide cytological screening program for residents, and the screening is performed every two years after the age of 20. There are also screening programs provided by the workplaces in Japan. According to the National Health Survey 2019, the checkup rates of any type of cervical cancer screenings are low: 15.1% for those aged 20-24, 36.6% for those aged 25-29, and 49.4% for those aged 30-34. Statistics are reported every year for the nationwide screening, and according to them, the positive screening rate is 2.1% for all ages, but 4.5% and 3.2% for those in their 20s and 30s, respectively. On the other hand, the percentage of people with positive test results who undergo follow-up examinations or confirmatory tests should be at least 90%, but it is 72.1% for all ages, 72.0% for those in their 30s, and even lower for those in their 20s, at 67.1%. Improving the rate of people getting screenings and subsequent examinations is a challenge even among the young.
宫颈癌在 20 多岁和 30 多岁人群中高发。宫颈癌的特征是存在癌前病变，可以通过癌症筛查检测到；一些癌前病变可以治疗，可以阻止其进展为浸润性癌症。因此，宫颈癌筛查已被证明可以降低浸润性癌症的发病率和死亡率。另一方面，许多癌前病变不会进展为浸润性癌症，而是停滞或自发消失。在日本，有一个针对居民的全国性细胞学筛查计划，20 岁以后每两年进行一次筛查。日本的工作场所也提供筛查计划。根据 2019 年全国健康调查，任何类型的宫颈癌筛查检查率都很低：20-24 岁人群为 15.1%，25-29 岁人群为 36.6%，30-34 岁人群为 49.4%。每年都会报告全国范围内的统计数据，根据这些数据，所有年龄段的阳性筛查率为 2.1%，但 20 多岁和 30 多岁人群的阳性筛查率分别为 4.5%和 3.2%。另一方面，阳性检测结果的人进行随访检查或确认检查的比例至少应达到 90%，但所有年龄段的比例为 72.1%，30 多岁的比例为 72.0%，而 20 多岁的比例甚至更低，为 67.1%。提高年轻人的筛查和后续检查率是一个挑战。
