常熟市农村妇女“两癌”筛查新方法效果分析

Effectiveness analysis of new methods of cervical & breast cancer screen-ing for Changshu rural women

目的 探讨将宫颈薄层液基细胞学检查（TCT）技术和乳腺超声用于妇女“两癌”（宫颈癌和乳腺癌）筛查的效果。方法 2013~2014年为常熟市35~64岁妇女开展“两癌”筛查,宫颈癌初筛应用TCT,乳腺癌初筛应用临床查体和彩超检查,对初筛阳性者进行进一步检查,以宫颈癌检出率、宫颈癌及癌前病变检出率、乳腺癌检出率作为评估指标,并与2010~2011年采用巴氏涂片筛查宫颈癌、乳腺临床查体筛查乳腺癌的结果进行比较。结果“两癌”检查新方法实施2年,共完成宫颈癌筛查100 075人,宫颈癌检出率为29.98/10万,宫颈癌及癌前病变检出率为296.78/10万;乳腺癌筛查76 014人,乳腺癌检出率为90.77/10万;“两癌”检出率明显高于2010~2011年的老方法。结论 将TCT技术用于宫颈癌筛查、乳腺超声用于乳腺癌筛查可以有效提高农村妇女“两癌”的早期预防、早期诊断和早期治疗,应建立一套合理有效的管理机制,从而降低妇女“两癌”发病率和死亡率。

Objective To discuss the efficacy of thinprep cytologic test （TCT） and breast ultrasound for screening cervi- cal cancer and breast cancer （＂Two Cancers＂） in the rural area of Changshu City. Methods The screening of ＂Two Cancers＂ was carried out for rural women aged 35-64 in Changshu City during 2013 to 2014. TCT was applied for pre- liminary screening of cervical cancer. Meanwhile, the physical examination and Color Doppler Ultrasound were used to screen the preliminary breast cancer. For those women whose preliminary screening results were positive, further exam- inations were needed. The accuracy of the positive findings was evaluated by the detection rates of cervical cancer, pre- cancerous lesion, and breast cancer. Then the rates were compared with those by the Pap test and the physical exami- nations during 2010 to 2011. Results The new screening methods of ＂Two Cancers＂ had been carried out for 2 years. 100 075 people had finished cervical cancer screening, the detection rate of cervical cancer was 29.98/100 000, the de- tection rate of cervical cancer and precancerous lesion was 296.78/100 000. 76 014 people had finished the breast can- cer screening with the detection rate of 90.77/100 000. The detection rates of ＂Two Cancers＂ with the new methods were significantly higher than those of old methods during 2010 to 2011. Conclusion The application of TCT technique for the screening of cervical cancer and breast ultrasound for the screening of breast cancer have made the early pre- vention, early diagnosis and early treatment for rural women more effectively. A set of rational and effective manage- ment mechanism has been established, which has reduced the morbidity of ＂Two Cancers＂ for rural women.