Zu Yue-E, Wang Si-Feng, Peng Xing-Xing, Wen Yong-Chun, Shen Xue-Xiang, Wang Xiao-Lan, Liao Wen-Bo, Jia Ding, Liu Ji-Yang, Peng Xiang-Wen
Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care, Hunan Normal University, Changsha 410001, Hunan Province, China.
Changsha Hospital for Maternal & Child Health Care Affiliated, Hunan Normal University, Changsha 410001, Hunan Province, China.
World J Clin Oncol. 2024 Dec 24;15(12):1491-1500. doi: 10.5306/wjco.v15.i12.1491.
Cervical cancer is the second leading cause of death in women worldwide, second only to breast cancer. Around 80% of women have been infected with human papillomavirus (HPV) in their lifetime. Early screening and treatment are effective means of preventing cervical cancer, but due to economic reasons, many parts of the world do not have free screening programs to protect women's health.
To increase HPV cervical cancer screening in Changsha and reduce the incidence of cervical cancer.
Cervical cancer screening included gynecological examination, vaginal secretion examination and HPV high-risk typing testing. Cervical cytology examination (ThinPrep cytology test) was performed for individuals who test positive for HPV types other than 16 and 18. Vaginal colposcopy examination was performed for HPV16 and 18 positive individuals, as well as for those who were positive for ThinPrep cytology test. If the results of vaginal colposcopy examination were abnormal, histopathological examination was performed. We conducted a cost-benefit analysis after 4 years.
From 2019 to 2022, 523437 women aged 35-64 years in Changsha city were screened and 73313 were positive, with a 14% positive rate. The detection rate of precancerous lesions of cervical cancer was 0.6% and the detection rate of cervical cancer was 0.037%. Among 311212 patients who underwent two cancers examinations, the incidence rate was reduced by more than half in the second examination. The average screening cost per woman was 120 RMB. The average cost of detecting early cases was 10619 RMB, with an early detection cost coefficient of 0.083.
Our screening strategy was effective and cost-effective, making it valuable for early diagnosis and treatment of cervical cancer. It is worth promoting in economically limited areas.
宫颈癌是全球女性第二大死因，仅次于乳腺癌。约80%的女性一生中曾感染人乳头瘤病毒（HPV）。早期筛查和治疗是预防宫颈癌的有效手段，但由于经济原因，世界上许多地区没有免费的筛查项目来保护女性健康。
提高长沙市HPV宫颈癌筛查率，降低宫颈癌发病率。
宫颈癌筛查包括妇科检查、阴道分泌物检查和HPV高危分型检测。对HPV 16和18型以外检测阳性的个体进行宫颈细胞学检查（薄层液基细胞学检测）。对HPV 16和18型阳性个体以及薄层液基细胞学检测阳性者进行阴道镜检查。如果阴道镜检查结果异常，则进行组织病理学检查。4年后进行成本效益分析。
2019年至2022年，长沙市共筛查35至64岁女性523437人，阳性73313人，阳性率为14%。宫颈癌癌前病变检出率为0.6%，宫颈癌检出率为0.037%。在311212例接受两项癌症检查的患者中，第二次检查的发病率降低了一半以上。每名女性的平均筛查成本为120元人民币。早期病例的平均检测成本为10619元人民币，早期检测成本系数为0.083。
我们的筛查策略有效且具有成本效益，对宫颈癌的早期诊断和治疗具有重要价值。值得在经济有限的地区推广。
