Nakamura Kazuto, Kigure Keiko, Nishimura Toshio, Yamashita Soichi
Department of Gynecology, Gunma Prefectural Cancer Center, 617-1 Takabayashi-nishi, Ota, Japan.
BMC Womens Health. 2024 Jul 16;24(1):402. doi: 10.1186/s12905-024-03256-z.
The incidence of cervical intraepithelial neoplasia is increasing in Japan. Although human papillomavirus (HPV) vaccination and cancer screening are crucial in preventing cancer-related mortality, the cervical cancer screening rate in Japan was only approximately 43.6% in 2022. This study aimed to conduct an epidemiological analysis of cervical cancer by collecting data from individual patients.
A questionnaire survey was administered to patients who visited our hospital between January 2017 and July 2023 owing to abnormal cervical cytological findings or a cancer diagnosis. Patients answered questions regarding their history of cervical cancer screening as well as their knowledge of HPV and cervical cancer.
During the study period, 471 patients participated in the survey, with 35 declining to participate. Patients with Stage 1b1-4b primarily sought medical attention due to self-reported symptoms (P < 0.001); however, they were less likely to have undergone cervical cancer screening (P < 0.001). Additionally, older patients were less likely to be aware of the association of HPV with cervical and other cancers. Notably, 28 of the 129 patients with stage 1b1-4b cancer underwent cervical cancer screening within 2 years. The tumor location within the endocervical canal emerged as a significant factor contributing to the difficulty for an accurate diagnosis of precancerous or cervical cancer during cervical screening. Furthermore, non- squamous cell carcinoma (SCC) histology was another possible factor.
Our findings suggest the need to widely disseminate information regarding the significance of cancer screening to increase cancer screening rates. Moreover, establishing strategies for improving the accuracy of detecting lesions during screening for non-SCC and endocervical canal tumors is crucial.
日本宫颈上皮内瘤变的发病率正在上升。尽管人乳头瘤病毒(HPV)疫苗接种和癌症筛查对于预防癌症相关死亡至关重要,但2022年日本宫颈癌筛查率仅约为43.6%。本研究旨在通过收集个体患者的数据对宫颈癌进行流行病学分析。
对2017年1月至2023年7月因宫颈细胞学检查异常或癌症诊断而就诊于我院的患者进行问卷调查。患者回答了有关宫颈癌筛查史以及他们对HPV和宫颈癌的了解情况的问题。
在研究期间,471名患者参与了调查,35名拒绝参与。1b1 - 4b期患者主要因自我报告的症状寻求医疗关注(P < 0.001);然而,他们接受宫颈癌筛查的可能性较小(P < 0.001)。此外,老年患者不太可能知晓HPV与宫颈癌及其他癌症的关联。值得注意的是,129例1b1 - 4b期癌症患者中有28例在2年内接受了宫颈癌筛查。宫颈管内的肿瘤位置成为宫颈筛查期间准确诊断癌前病变或宫颈癌困难的一个重要因素。此外,非鳞状细胞癌(SCC)组织学是另一个可能因素。
我们的研究结果表明,有必要广泛传播有关癌症筛查重要性的信息以提高癌症筛查率。此外,制定提高非SCC和宫颈管肿瘤筛查期间病变检测准确性的策略至关重要。