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目的通过对湘西自治州少数民族地区20年间不同民族妇女子宫颈癌患者的分布情况进行分析,发现新时期子宫颈癌的发病特点,为本地区子宫颈癌的早期预防提供理论及实践依据。方法对1987-2006年间湘西自治州少数民族地区七县一市共18家县及县级以上医院收治的1030例宫颈癌患者的临床资料按民族分布、患者年龄及病理类型逐年统计后进行分析。结果近20年来我国自治州子宫颈癌发病总人数呈持续增加趋势,不同民族又各有其分布特点,苗族妇女为子宫颈癌高发人群,20年间发患者数所占比例一直位居首位且逐年持续增加;土家族妇女则基本维持在15%~25%的水平,两民族间变化比较差异显著。好发年龄苗族妇女呈年轻化趋势;土家族妇女则一直为45~55岁。<35岁的年轻患者占患者总数的比苗族妇女呈逐年上升趋势(P<0·05);土家族妇女基本维持在7~9%的水平。腺癌所占比例苗族妇女逐年上升,而土家族妇女则维持在7%~8%水平。≥65岁子宫颈癌患者的构成比苗族妇女呈下降趋势,土家族妇女维持在4%~6%之间。以上各方面的变化两民族间比较均有统计学意义。结论筛查干预年龄应从传统的围绝经期延伸到年轻、有性生活的妇女;要关注不同民族间的差异,根据子宫颈癌在不同民族分布特点的不同选择该民族防治的重点人群;加强卫生知识宣教,节制、约束不良性行为;健全妇女保健网。
Objective To analyze the distribution of cervical cancer patients from different ethnic groups in ethnic minority areas of Xiangxi Autonomous Prefecture in the past 20 years and find out the characteristics of cervical cancer in the new period and provide theoretical and practical evidence for the early prevention of cervical cancer in this region. Methods The clinical data of 1030 cervical cancer patients treated in 18 counties and above county level in seven counties and one city of Xiangxi Autonomous Prefecture from 1987 to 2006 were analyzed year by year by ethnic distribution, patient age and pathological type. Results The total number of cervical cancer in China’s autonomous prefectures has been increasing continuously in recent 20 years, and different ethnic groups have their own distributional characteristics. Miao women are the most common cervical cancer patients. The incidence of cervical cancer is the highest in 20 years Increase; Tujia women basically maintained at the level of 15% ~ 25%, two ethnic groups showed significant differences. Miao women of good age are younger trend; Tujia women have been 45 to 55 years old. Young patients <35 years old accounted for a year-on-year increase (P <0.05), compared with Miao women; Tujia women basically maintained at 7-9%. The proportion of Adenocarcinoma Miao women increased year by year, while Tujia women remained at 7% to 8% level. The composition of patients with cervical cancer ≥65 years showed a decreasing trend compared with Miao women, and Tujia women maintained at between 4% and 6%. The above two aspects of the changes between the two ethnic groups were statistically significant. Conclusion The screening intervention should extend from the traditional perimenopausal women to young women with sexual life. To pay attention to the differences among different ethnic groups and select the key population for prevention and treatment of cervical cancer according to the distribution characteristics of different ethnic groups, Knowledge and education, restraint, restraint of bad behavior; improve women’s health network.