山西省襄垣县宫颈癌和乳腺癌联合筛查效果初探

Evaluation of the effect of national combined screening project for cervical cancer and breast cancer in Xiangyuan county,Shanxi,China

目的通过分析为国家宫颈癌和乳腺癌筛查提供基本评价数据。方法 2009～2010年山西省襄垣县妇幼保健院对该县30～59岁妇女通过醋酸/碘染色后肉眼观察方法开展宫颈癌筛查,阳性者转诊阴道镜,镜下有病变时取活检,以病理诊断为金标准。对35～59岁的妇女开展乳腺癌筛查,以临床检查法为初筛方法,怀疑阳性者通过超声或乳腺X线进行诊断。结果 2009年完成1993名妇女的宫颈癌筛查,其中宫颈上皮内瘤变2级(CIN2)及以上病变的患病率为1.6%,早诊率为100%,第2年复查率为91%,仅查出1例CIN2,未查出更高病变,早诊率达100%。完成1819名妇女的乳腺癌筛查,乳腺良性病变9例(4.02%),良性肿瘤3例(1.34%);2010年完成2026名妇女的乳腺癌筛查,良性病变103例(13.57%),良性肿瘤14例(1.84%),可疑恶性1例。结论该县宫颈癌的筛查效果明显,乳腺癌筛查仍需加强技术培训。筛查体系和技术队伍建设是基层单位承担农村妇女健康保健服务的关键。

Objective To provide data for the evaluation of Chinese national screening project for cervical cancer and breast eancer. Methods From 2009 to 2010, women aged 30 - 59 yrs old were screened for cervical cancer by visual in- spection with acid （VIA） and Lugol＇s iodine （VILI） in Women and Children＇s Hospital of Xiangyuan county, Shanxi, Chi- na. Biopsies under eolposcopy were taken if any abnormalities were found by VIA and VILI for pathological confirmation. Women aged 35 -59 yrs old were screened for breast cancer by clinical breast examination （CBE）, and referred to mam- mography or ultrasound if any abnormality was observed. Results A total number of 1993 women were screened for cervical cancer in 2009 and the prevalence of cervical intraepithelial neoplasia 2 or worse （ CIN2 ＋ ） was 1.6% , with an early detection rate of 100% in 2009. About 90% women were called back in 2010, and only one case with CIN2 was detected, showing an early detection rate of 100%. For breast cancer, 1819 women were screened in 2009, and 9 cases of benign le- sions （4. 02% ）, 3 cases of benign tumors （ 1.34% ） were detected. A total number of 2026 women were screened in 2010, among which 103 cases of benign lesions （ 13.57% ）, 14 cases of benign tumors （ 1.84% ） and 1 case of suspicious malignant lesion were found. Conclusion Cervical cancer screening showed good efficacy while breast cancer results ne- cessitate further training in Xiangyuan County. Formal long-term systems for cancer screening and professional team are the two key issues for the successful delivery of health service for women in rural China.