某省20～65周岁已婚妇女宫颈癌及癌前病变发病率的贝叶斯估计

Bayesian estimation of incidences of cervical carcinoma and cervical precancerous lesion in women aged 20 to 65 years in a given province

目的：估计某省宫颈癌癌前病变CINII°及以上（CINIII°、宫颈癌）的发病率，并为宫颈癌的防治提供依据。方法：对该省20—65周岁已婚妇女进行宫颈癌筛查，并对部分筛查正常者隔年随访，通过贝叶斯方法估计发病情况。结果：共进行113134例。累计226972．33人年随访，其中1846例细胞学阳性需进行病理学检查，最终收到1510份病理结果，检出CINII°及以上者442例；通过贝叶斯法考虑病理检查随访人群中的失访病例以及细胞学检查阴性人群中的漏诊病例，估计得该省宫颈癌癌前病变CINII°及以上的发病率为283．79／10万，95％可信区间（201．58，393．06）／10万。结论：基于贝叶斯法，考虑了病理检查失访人群中的失访病例以及细胞学检查阴性人群中的漏诊病例，估计得到的该省宫颈癌癌前病变CINII°及以上的发病率更合理、更准确。

Objective ： To estimate the incidences of cervical intraepithelial neoplasia （CIN） II or worse （ CIN III, cervical carcinoma） in a given province, and to provide the basis for the prevention and treatment of cervical cancer. Methods： Mar- ried women aged 20 - 65 years in the province accepted cervical cancer screening, and those with normal screening results were followed - up every other year. The incidences of CIN II or worse in the province were estimated with Bayesian method. Results ： A total of 113 134 women were followed up for 226 972.33 person - year totally. In addition, 1846 women with posi- tive cytology experienced cervical histopathological examinations, and 1510 pathologic diagnoses were obtained finally. A total of 442 cases of CIN II or worse were detected. The incidences of CIN II or worse was 283.79/100 thousand, and 95% confi- dence interval （CI） was calculated as （201.58,393.06）/100 thousand. Conclusion： Considering the follow - up failing eases in the pathologic examinations and the missed cases in the negative cytology diagnoses of the subjects, the incidence of CIN II or worse should be more reasonable and accurate, if it is based on the Bayesian method.