武汉市20余万农村妇女宫颈癌和乳腺癌筛查情况分析

Analysis on cervical cancer and breast cancer screening situations among two hundred thousand rural women in Wuhan city

目的:了解武汉市农村妇女宫颈癌和乳腺癌患病情况及相关因素。方法:采用液基薄层细胞学技术(TCT)和DNA倍体定量分析技术检测宫颈脱落细胞,初筛阳性者采用阴道镜下取宫颈活体组织进行病理检查;采用触诊及彩色多普勒超声进行乳腺检查,初筛阳性者行钼靶摄片检查或乳腺穿刺行细胞学检查。对所有初筛阳性者进行问卷调查,了解一般人口学情况、环境因素、遗传因素、既往史及现病史、女性个人健康史、生活习惯及饮食习惯以及社会心理因素等因素。结果:全市共对202 067例妇女进行"两癌"筛查,共检出宫颈癌前病变770例、宫颈癌33例(27.13/10万),乳腺癌32例(23.85/10万)。对"两癌"影响因素分析提示:HPV感染、宫颈癌家族史、基础妇科疾病、初次性行为年龄早是宫颈癌前病变发生的危险因素;HPV感染、初次生育年龄早以及经历不良生活事件是宫颈癌发生的危险因素;初婚年龄晚、文化程度低、经常使用电脑或电视机、有癌症家族史、流产及引产史是乳腺癌发生的危险因素。结论:通过开展宫颈癌和乳腺癌筛查,起到早发现、早诊断、早治疗的作用,对降低宫颈癌和乳腺癌的发病率及死亡率具有重要的意义。将来需根据"两癌"高危因素进一步加强针对性的健康教育工作,完善"两癌"筛查与随访制度,保障妇女的生殖健康。

Objective： To understand the prevalences and related factors of cervical cancer and breast cancer among the rural women in Wuhan city. Methods： Thinprep cytologic test （TCT） technology and DNA ploidy quantitative analysis were used to detect cervi- cal exfoliated cells among rural women in Wuhan city, and the abnormal ones were tested by biopsy under colposcopy and pathological exami- nation; palpation and color Doppler ultrasound were used to examine breast mammary, and the abnormal ones received molybdenum target photography and cytological test after breast puncture. The survey objects who were positive in initial screening were investigated by a ques- tionnaire, the contents included general demographic factors, environmental factors, genetic factors, disease history, individual health histo- ry, life style, eating habits, as well as social and psychological factors. Results： A total of 202 067 women were screened in Wuhan city, 770 cases were found with cervical precancerous lesions, 33 cases were found with cervical cancer, and 32 cases were found with breast cancer , the prevalence rate of cervical cancer was 27. 13/100 000, while the prevalence rate of breast cancer was 23.85/100 000. The a- nalysis of influencing factors of cervical cancer and breast cancer showed that HPV infection, family history of cervical cancer, basic gyneco- logical diseases, and early age of first sexual intercourse were risk factors of cervical precancerous lesions ; HPV infection, early age of first birth, and the experience of adverse life events were risk factors of cervical cancer; while late at first marriage, low education level, using computer or TV frequently, family history of cancer, history of abortion and induced abortion were risk factors of breast cancer. Conclusion ： Carrying out cervical cancer and breast cancer screening can lead to early detection, early diagnosis and early therapy, which is of great im- portance for reducing the incidence rate and mortality rate of cervical cancer and breast cancer. Corresponding health education shouhl be strengthened according to the risk factors, and the screening system and follow - up system should be improved in future so as to protect re- productive health of women.