甘孜地区宫颈癌筛查情况及妇女对宫颈癌和HPV相关知识认知程度调查

Screening of Cervical Cancer in Garze area and Women's Cognition Degree Towards Cervical Cancer and HPV Related knowledge

目的:探究甘孜地区妇女宫颈癌筛查情况及其认知程度。方法:回顾性分析近2年于甘孜藏族自治州人民医院行宫颈癌筛查后实施阴道镜活检的1913例次妇女临床资料,以阴道镜活检结果为"金标准",分析各筛查方法诊断效能。选取其中参与宫颈癌认知调查者330例,比较不同年龄、文化程度、婚姻状况、家庭月收入受试妇女宫颈癌筛查信念量表评分结果差异。结果:单纯液基薄层细胞学检查(TCT)<单纯人乳头状瘤病毒(HPV)检查<联合检查(均P<0.05),且单纯HPV检查及联合检查与阴道镜活检结果一致性均属良好(均Kappa>0.7)。宫颈癌筛查信念量表评分结果显示,年龄19～29岁>30～岁>40～岁(均P <0.05),而40～岁、50～岁及60～岁年龄段间比较均无统计学意义(均P>0.05);文化程度初中及以下>高中或中专>大专及以上(均P <0.05);已婚<未婚/离异(P <0.05);家庭月收入～1500元>～3000元>～4500元>4500元以上(均P <0.05);筛查服务获取渠道由单位/社区提供>医师推荐>自愿前往(均P<0.05)。结论:TCT联合HPV检查诊断宫颈癌效能较高,有条件的受检妇女推荐以此作为筛查项目,参与调查妇女对宫颈癌和HPV相关知识认知程度欠佳,需结合个体情况开展针对性宣教干预。

Objective: To explore the screening of cervical cancer in women in Garze area and their cognition degree. Methods: The clinical data of 1913 women who underwent colposcopy biopsy after cervical cancer screening in the People' s Hospital of Ganzi Tibetan Autonomous Prefecture in the past 2 years were retrospectively analyzed. The results of colposcopy biopsy were used as the gold standard to analyze the diagnostic efficacy of each screening method. A total of 330 patients who participated in cervical cancer cognition survey were selected, and the differences in scores of cervical cancer screening belief scales among women of different ages, education levels, marital status and family monthly income. Results: Simple Thinprep cytology test (TCT)<simple human papillomavirus (HPV) examination <combined examination (all P<0.05), and the consistencies of HPV examination and combined examination with colposcopy biopsy results both were good (both Kappa>0.7). The results of cervical cancer screening belief scales scores showed age ranged from 19 to 29 years old >30~ years old >40~ years old (all P<0.05), and there was no statistical significance between age groups of 40~ years old, 50~ years old and 60~ years old (all P>0.05), and education level with junior high school and below>high school or technical secondary school>juniorcollege and above (all P<0.05), and married <unmarried/divorced (P<0.05), and the family monthly income with ~1500 yuan>~ 3000 yuan>~ 4500 yuan>4500 yuan or more (all P<0.05). The screening service access channels provided by the unit/community >physician recommendation >voluntary offer (all P<0.05). Conclusions: TCT combined with HPV examination is more effective in the diagnosis of cervical cancer. Conditional women recommend it as a screening project to investigate women's poor knowledge of cervical cancer and HPV. It is necessary to carry out targeted education and intervention in combination with individual conditions.