Nieminen P, Kallio M, Hakama M
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland.
Obstet Gynecol. 1995 Jun;85(6):1017-21. doi: 10.1016/0029-7844(95)00063-W.
To describe the efficacy of the Finnish mass screening program for cervical squamous carcinoma and adenocarcinoma, as reflected by changes of incidence and mortality rate.
Cervical cancer incidence and mortality data were obtained from the Finnish Cancer Registry. Data were available from the year 1953, when the registry was established. The nationwide mass screening program in Finland was started in the mid-1960s. A centralized organization administers this program. Women age 30-60 years are notified for screening every 5 years.
The mean incidence of cervical carcinoma in the early 1960s was 15.4 per 10(5) woman-years. In 1991, it was only 2.7 per 10(5) woman-years. The mortality rate has decreased in the same proportion since the mass screening program. In the early 1960s, the mortality was 6.6 and in 1991 1.4 per 10(5) woman-years. However, the decrease of the incidence is seen almost exclusively in squamous cell carcinomas. The mortality caused by adenocarcinoma has decreased in screened birth cohorts, but the incidence rate has remained the same.
The Finnish mass screening program has been effective and its continuation is of utmost importance. In the future more attention should be given to glandular cell atypias in cervical smears. Thus, it might be possible to decrease the incidence of cervical adenocarcinoma.
通过发病率和死亡率的变化来描述芬兰宫颈癌鳞状细胞癌和腺癌大规模筛查项目的效果。
宫颈癌发病率和死亡率数据来自芬兰癌症登记处。数据可追溯到1953年登记处成立之时。芬兰的全国性大规模筛查项目始于20世纪60年代中期。该项目由一个中央组织管理。30至60岁的女性每5年被通知进行筛查。
20世纪60年代初宫颈癌的平均发病率为每10（5）女性年15.4例。1991年，这一数字仅为每10（5）女性年2.7例。自大规模筛查项目开展以来，死亡率也以相同比例下降。20世纪60年代初，死亡率为每10（5）女性年6.6例，1991年为1.4例。然而，发病率的下降几乎完全体现在鳞状细胞癌上。腺癌导致的死亡率在接受筛查的出生队列中有所下降，但发病率保持不变。
芬兰的大规模筛查项目是有效的，继续开展该项目至关重要。未来应更加关注宫颈涂片检查中的腺细胞异型性。这样，有可能降低宫颈腺癌的发病率。
