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目的:通过21个乡镇8 866例农村妇女宫颈癌筛查,了解景宁畲族自治县宫颈癌及宫颈上皮内瘤变(CIN)发病情况,为今后农村妇女宫颈癌防治提供依据。方法:按照卫生部有关宫颈癌检查项目管理方案的要求,2012年3月至2015年9月对全县21个乡镇、年龄在35~64岁的农村妇女进行免费宫颈癌筛查,初筛采用宫颈脱落细胞巴氏检查涂片染色、TBS分类系统报告,结果可疑或异常者行阴道镜检查,阴道镜检查结果可疑或异常者再进行组织病理学检查的“三阶梯”程序,确诊及统计口径均为组织病理学检查结果。结果:免费宫颈癌筛查共8 866例,平均年龄为49.5岁,其中宫颈脱落细胞巴氏检查涂片染色结果可疑或异常者356例(阳性率40.15‰),宫颈脱落细胞检查阳性率各年龄组存在差异,其中45岁~组最高,为44.87‰,宫颈组织病理学检出异常121例,阳性率为13.65‰,各年龄组存在差异,其中45岁~组最高,为16.68‰,明显高于其它两个年龄组,组织病理学诊断宫颈上皮内瘤变(CIN)患者112例(患病率12.36‰)、宫颈癌患者9例(患病率1.02‰),各年龄组间患病率无明显差异。结论:景宁县农村妇女宫颈癌及宫颈上皮内瘤变患病率较高,有必要加强宫颈癌防治知识宣教,提高农村妇女对宫颈癌的认识和自我保健意识,同时加大筛查力度与频率,特别是35~64岁妇女仍是筛查重点,尽可能提高筛查覆盖率,促使宫颈癌早发现、早诊断、早治疗,降低该县宫颈癌发病率和死亡率。
Objective: To investigate the incidence of cervical cancer and cervical intraepithelial neoplasia (CIN) in 28 866 rural women in 21 towns and villages in Jingning She Autonomous County, and to provide basis for future prevention and treatment of cervical cancer in rural women. Methods: According to the requirements of the Ministry of Health about cervical cancer screening program management, from March 2012 to September 2015, free cervical cancer screening was carried out in 21 townships and rural women aged 35-64 years in the county. Cervical exfoliated cells Pap smear staining, TBS classification system report, the results were suspicious or abnormal colposcopy, colposcopy results were suspicious or abnormal histopathological examination of the “three-step” program, diagnosed and Statistics are histopathological examination results. Results: A total of 866 cases of cervical cancer screening were free, with an average age of 49.5 years. There were 356 cases with suspicious or abnormal Pap smear results of cervical exfoliated cells (the positive rate was 40.15 ‰). The positive rates of cervical exfoliative cells were all ages There were differences among the groups, 45 of them were the highest, 44.87 ‰, 121 were abnormal cervical tissue pathology, the positive rate was 13.65 ‰, there were differences among all age groups, of which the highest in group 45 was 16.68 ‰, which was significantly higher In the other two age groups, 112 patients with histological diagnosis of cervical intraepithelial neoplasia (CIN) (prevalence rate of 12.36 ‰), 9 patients with cervical cancer (prevalence rate of 1.02 ‰), the prevalence of each age group No significant difference. Conclusion: The prevalence of cervical cancer and cervical intraepithelial neoplasia in rural women in Jingning County is high. It is necessary to strengthen knowledge and education on cervical cancer prevention and treatment to raise rural women’s awareness of cervical cancer and awareness of self-care, and at the same time increase the intensity of screening and frequency , Especially women aged 35-64 are still the screening focus, as far as possible to improve screening coverage, prompting early detection of cervical cancer, early diagnosis and early treatment to reduce the incidence of cervical cancer in the county and mortality.