新疆塔城农村地区汉族和哈萨克族妇女宫颈癌发病率及相关高危因素分析

Analysis of incidence and high risk of relevant factors of cervical cancer in women of Han and Kazak in rural areas of Tacheng, Xinjiang

目的了解新疆塔城农村地区汉族及哈萨克族妇女宫颈癌发生率,探讨相关的高危因素。方法选择塔城农村地区汉族及哈萨克族妇女3 293人筛查宫颈癌,采用病例对照,调查受检者病史、个人情况等宫颈癌相关因素,进行高危型HPV检查及宫颈液基细胞学检查,对ASC-US及以上者,行阴道镜检查及病理检测。结果 2014年1月─2015年6月调查塔城农村地区参加宫颈癌筛查项目的汉族和哈萨克族妇女3 293人,高危型HPV感染率分别为11.7%和5.8%(χ2=34.22,P<0.05),宫颈癌患病率分别为0.6%、0.4%(χ2=3.97,P<0.05);初次性生活年龄低于18岁,汉族和哈萨克族发生率分别为14.4%、9.3%(χ2=19.32,P<0.05),配偶包皮过长或包茎发生率分别为60.2%和6.7%(χ2=993.32,P<0.05);汉族和哈萨克族妇女合并滴虫感染率分别为12.6%和7.2%(χ2=183.10,P<0.05)。结论塔城地区农村妇女宫颈癌发病率和高危型HPV感染率汉族均高于哈萨克族,过早性生活、配偶外生殖器卫生状况及感染滴虫性阴道炎为发病的高危因素,应重视对目标人群相关的健康教育,从而降低宫颈癌的发病率。

Objective To know incidence of cervical cancer in women of Han and Kazak in rural areas of Tacheng, Xinjiang, to investigate high risk of relevant factors. Methods Totally 3 293 women of Han and Kazak in rural areas of Tacheng, Xinjiang were selected to carry out cervical cancer screening by case control, survey of case history and personal information, examination of high risk HPV and cervical liquid based cytology. Women with ASC-US took colposcopy and pathological detection. Results From January 2014 to June 2015, 3 293 women took cervical cancer screening, with infection rate of high risk HPV of 11.7% and 5.8% of the Han and Kazak, respectively（χ^2=34.22, P〈0.05）, and prevalence of cervical cancer of 0.6% and 0.4%, respectively（χ^2=3.97, P〈0.05）. The first sex life occurred at the age younger than 18 years, with the incidence rate of 14.4% and 9.3% of the Han and Kazak, respectively（χ^2=19.32, P〈0.05）. The incidence of redundant prepuce or phimosis of spouse was 60.2% and 6.7% of the Han and Kazak, separately（χ^2=993.32, P〈0.05）. The concurrent infection rate of trichomonas of these women was 12.6% and 7.2%（χ^2=183.10, P〈0.05）. Conclusions The infection rate of high risk HPV and incidence of cervical cancer of the women in rural areas of Tacheng are higher in the Kazak than in the Han, with the high risk of factors of prematurity sex life, health status of external genitalia of their spouses and infection with trichomonas vaginitis. Health education should be developed in the focus people so as to decrease the incidence of cervical cancer.