中山市35～59岁妇女免费乳腺癌普查模式及结果分析

Analysis of free screening model and result of breast cancer in women aged 35-59 years in Zhongshan City

目的 通过对2011年35～～59岁妇女免费乳腺癌普查模式及结果分析,从中发现本模式乳腺癌普查管理中的薄弱环节,为完善本地乳腺癌筛查管理及政府乳腺癌防治提供依据. 方法 由调查员对普查妇女进行相关资料的询问填写,采用临床触诊加高频B超相结合筛查方法,同时现场进行信息录入,阳性妇女及时追踪. 结果 47 768例普查妇女中1BI-RADS分级中未见异常共29 755例,占62.29％.发现异常18 013例,占37.71％.复诊率25.3％;活检154例,活检率0.32％,其中良性病变112例,占72.73％;癌前病变11例,占7.14％;乳腺癌31例,占20.13％,乳腺癌检出率64.89/10万,早期癌19例,占61.29％.本次普查高频超声敏感性达到80.65％,阴性预测值达到93.88％. 结论 临床触诊与高频超声相结合模式筛查乳腺癌具有较高的敏感性及阴性预测值,经济方便,适宜于中小城市及农村推广;中山市乳腺癌发病率仍处于较高水平,复诊率偏低,信息化管理可以及时随访阳性妇女,同时加强健康宣教,建立乳腺癌普查的长效机制,提高早诊早治率.

Objective Through analysis of free screening model and result of breast cancer in women aged 35 - 59 years in Zhongshan City, to find weak links and improve the management, and to provide a basis for the prevention and control of the cancer. Methods A census was carried out by investigators with designed questionnaire on the women attending the screen- ing. Breast cancer was screened by clinical palpation and high frequency B uhramund. The women with lxxsitive results were fol- lowed up. Results In 47,768 cases with BI RADS classification, 29,775 were normal, accounting for 62.29 %. 18,013 cases were abnormal, accounting for 37.71%. The return visit rate was 25.3 %. 0.32 % （154/47,768） had biopsy, in which 72.73% （112/154） were found to have benign lesions, 7.14% （11/154） to have precancerous lesions, and 20.13% （31/154） to have breast cancer. The detection rate of breast cancer was 64.89/10 million. 61.29% （ 19/31 ） of the cancer was in the early stage. The sensitivity of the high- frequency ultrasound in screening was 80.65 %, and the negative predictive value was 93.88 %. Conclusions The screening of breast cancer by the combination of clinical palpation and high frequency ultra- sound has high sensitivity and negative predictive value. It is economical and convenient and suitable for popularization in small - medium cities and rural areas. The morbidity of breast cancer in Zhongshan City is at a high level. The return visit rate is low_ The digital management of information can help the follow- up of the women with positive results. Meanwhile, it is urgent to enhance health education, set up a long- term mechanism of breast cancer screening and improve the early diagnc,sis and early treatment rate.