Berndt H, Neuser D
Arch Geschwulstforsch. 1978;48(3):250-75.
There are remarkable differences of incidence and mortality from cervical cancer between countries and even within small countries. In developed industrial countries, incidence is slowly declining. Age distribution (middle--aged women are mostly afflicted) distinguishes cervical cancer from all other common malignant neoplasms. Known risk factors are: low social class, sexual activity early in youth, instable sexual relationships. Cervical cancer behaves like a veneral disease of low infectious power. Cervical cancer develops stepwise out of epithelial dysplasia and carcinoma in situ. The foundations of a cervical cancer control programme are laid: cytodiagnosis as screening method; well defined high risk groups; effective and not dangerous treatment of prephases and early stages of cancer. In the G.D.R. conditions for effective cancer control are good: cancer registration works stable for more than 20 years; it enables evaluation of effectivity. Cytologic screening can be fully integrated into basic gynecologic care. Medical care including prevention is free of fees and available for all women. The ultimate of goal of a cervical cancer control programme is primary prevention by detection and treatment of preneoplastic lesions (dysplasia and carcinoma in situ).
各国之间甚至小国国内,宫颈癌的发病率和死亡率都存在显著差异。在发达工业国家,发病率正在缓慢下降。年龄分布(中年女性居多)使宫颈癌有别于所有其他常见恶性肿瘤。已知的风险因素有:社会阶层低、年轻时过早进行性活动、性伴侣不稳定。宫颈癌表现得像一种传染性较低的性病。宫颈癌由上皮发育异常和原位癌逐步发展而来。宫颈癌控制计划的基础已经奠定:以细胞诊断作为筛查方法;明确界定高危人群;对癌前阶段和癌症早期进行有效且无危险的治疗。在民主德国,有效的癌症控制条件良好:癌症登记工作稳定开展了20多年;这使得能够评估有效性。细胞学筛查可完全融入基本妇科护理。包括预防在内的医疗护理免费提供给所有女性。宫颈癌控制计划的最终目标是通过检测和治疗癌前病变(发育异常和原位癌)进行一级预防。