Assistance Publique-Hôpitaux de Paris, Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, 178 rue des Renouillers, 92700, Colombes, France.
Université de Paris, Paris, France.
BMC Womens Health. 2022 Mar 30;22(1):97. doi: 10.1186/s12905-022-01668-3.
Cervical cancer is common worldwide. Despite the existence of primary and secondary prevention strategies, the survival rate is decreasing in France due to an increasing proportion of advanced-stage cancer. Our objective was to determine the factors associated with a diagnosis of cervical cancer at advanced stages in an urban population in France.
A retrospective study was conducted on all consecutive records of patients diagnosed with cervical cancer between January 2006 and December 2018 in a single center in Paris. The data collected were demographic characteristics, medical and gynecological history, circumstances of diagnosis, diagnostic and therapeutic management. The patients were divided into two groups according to the FIGO 2018 stage at diagnosis: group A stages IA1 to IB2 and group B advanced stages IB3 to IVB.
Among 96 patients who were diagnosed with cervical cancer, 25 (26%) were in group A and 71 (74%) in group B. Women in group B had less frequently received regular gynecological care than in group A (36% vs 84.2%, p < 0.001) and fewer had Pap test screening in the previous 3 years (30.4% vs 95.0%, p < 0.001). Parity greater than 3 was more frequent in group B (69.6% vs 42.9%, p = 0.031). The diagnosis was made during a routine examination or cervical smear in only 9.23% and 16.18% respectively in group B, versus 60% of cases in 45.82% of cases in group A (p < 0.001 and p = 0.003). Vaginal bleeding was observed in 85.29% in group B versus 36% in group A (p < 0.001). Histological type was squamous cell carcinoma 87.32% of group B and 56% of group A (p < 0.001).
Diagnosis of cervical cancers at advanced stages occurred mostly in women who did not benefit from the recommended screening. Universal access to screening is necessary for the prevention and early treatment of cervical cancer.
宫颈癌在全球范围内较为常见。尽管存在初级和二级预防策略，但由于晚期癌症比例增加，法国的生存率正在下降。我们的目的是确定与法国城市人群中晚期宫颈癌诊断相关的因素。
对 2006 年 1 月至 2018 年 12 月在巴黎的一家单一中心连续记录的所有宫颈癌患者进行了回顾性研究。收集的数据包括人口统计学特征、医疗和妇科病史、诊断情况、诊断和治疗管理。根据 2018 年 FIGO 分期，患者被分为两组：A 组（IA1 至 IB2 期）和 B 组（IB3 至 IVB 期）。
96 例宫颈癌患者中，25 例（26%）为 A 组，71 例（74%）为 B 组。B 组女性接受常规妇科检查的频率低于 A 组（36%比 84.2%，p<0.001），过去 3 年接受巴氏涂片筛查的频率也低于 A 组（30.4%比 95.0%，p<0.001）。B 组中多胎妊娠大于 3 次的比例更高（69.6%比 42.9%，p=0.031）。仅 9.23%和 16.18%的 B 组在常规检查或宫颈涂片时发现宫颈癌，而 A 组中有 60%的病例在 45.82%的病例中发现宫颈癌（p<0.001 和 p=0.003）。B 组中有 85.29%的患者出现阴道出血，而 A 组仅有 36%（p<0.001）。B 组的组织学类型为鳞状细胞癌，占 87.32%，A 组为 56%（p<0.001）。
晚期宫颈癌的诊断主要发生在未接受推荐筛查的女性中。为了预防和早期治疗宫颈癌，需要普及筛查。
