2011-2015年深圳市光明新区适龄女性两癌筛查情况及防治对策

Breast cancer and cervical cancer screening among the women of the right age in Guangming New District of Shenzhen city from 2011 to 2015 and the prevention and treatment measures

目的对深圳市光明新区适龄妇女两癌(乳腺癌及宫颈癌)进行筛查,根据筛查结果分析两癌发病特点,制定相应防治对策。方法选取2011年2月-2015年1月在该院辖区内筛查点进行筛查的适龄女性资料进行分析,资料来源于干部体检及免费两癌筛查。乳腺癌筛查方法:采用触诊及乳腺彩超对受检者进行乳腺癌初步筛查,对疑似病例、阳性受检者、高危人群转诊至上级医院进行乳腺靶向检查;宫颈癌筛查方法:由妇科医生进行常规妇检及阴道分泌物检查,并行液基细胞学(TCT)学检查,对结果为阳性受检者进行HPV检查,必要时行阴道镜取活检检查。结果本次共筛查12 686例女性,BI-RADS分级Ⅲ发生率各年龄段比较差异有统计学意义(P<0.05),各年龄段BI-RADS分级Ⅳ发生率比较,差异无统计学意义(P>0.05);TCT检测结果显示,宫颈癌筛查各年龄段比较差异有统计学意义(P<0.05),且39岁以下女性HPV阳性率明显高于40~49岁女性及50岁以上女性(P<0.05)。本次筛查中,乳腺癌确诊7例,宫颈癌确诊9例,各年龄段乳腺癌、宫颈原位癌及宫颈浸润癌患病率比较,差异均无统计学意义(均P>0.05),39岁以下女性CIN患病率明显高于40~49岁及50岁以上女性(P<0.05)。结论 39岁以下女性HPV及CIN患病率较高,40~49岁女性BI-RADS分级Ⅲ患病率、TCT检测阳性率较高,BIRADS分级Ⅳ多见于50岁以上女性。加强育龄期妇女两癌预防的宣传力度,每年针对各年龄段高发疾病进行重点筛查,以社区为单位,建立健康管理档案,将两癌预防及筛查列为健康体检必需项目,保证健康体检率及筛查率。

Objective To screen breast cancer and cervical cancer among the women of the right age in Guangming New District of Shenzhen city, analyze the characteristics of breast cancer and cervical cancer based on screening results, and develop corresponding prevention and treatment measures. Methods The data of women of the right age receiving breast cancer and cervical cancer screening in Guangruing New District of Shenzhen city from February 2011 to January 2015 was analyed, the scources included physical examination of cadres and free breast cancer and cervical cancer screening. Breast cancer screening： primary screening was performed based on palpation and ultrasonography, then mammary gland targeted inspection was conducted among the suspected, positive, and high-risk women in superior hospitals. Cervical cancer screening： the gynecologists carried out routine gynecological examination, examination of vaginal secretions, and liquid-based cytology test （TCT）, HPV examination was performed among the positive women, colposcopic biopsy was carried out if necessary. Results A total of 12 686 women were screened. There was statistically significant difference in the rate of BI-RADS category Ⅲ among different age groups （P〈0. 05 ） , but there was no statistically significant difference in the rate of BI-RADS category IV among different age groups （ P〉0. 05 ） . TCT results showed that there was statistically significant difference in cervical cancer screening rate among different age groups （P〈0. 05 ） . HPV positive rate among the women under 39 years old was statistically significantly higher than those among the women aged 40-49 years old and more than 50 years old （ P〈0. 05 ） . Seven patients with breast cancer and nine patients with cervical cancer were diagnosed definitely during this screening. There was no statistically significant difference in the prevalence rates of breast cancer, cervical cancer in situ, and invasive cervical cancer among different age groups （ all P〉0. 05 ） . The prevalence rate of CIN among the women under 39 years old was statistically significantly higher than those among the women aged 40-49 years old and more than 50 years old （ P〈0. 05 ） . Conclusion The prevalence rate of HPV infection and CIN among the women under 39 years old is relatively high ; the rate of BI-RADS category m and positive rate of TCT among the women aged 40-49 years old are relatively high ; the rate of BI-RADS category Ⅳ among the women more than 50 years old is high. The prevention and treatment measures of breast cancer and cervical cancer include strengthing publicity among the women of childbearing age, conducting annual key screening according to the diseases with high prevalence rate in each age group, taking breast cancer and cervical cancer prevention and screening as the necessary items during healthy physical examination with community as a unit, jsetting up health management files, and ensuring health examination rate and screening rate.