2015—2017年河北省农村妇女宫颈病变筛查项目数据分析

Analysis of cervical lesion screening of rural women in Hebei Province from 2015 to 2017

目的分析2015—2017年河北省农村妇女宫颈病变筛查项目的数据,评价项目开展实施情况。方法对2015—2017年河北省12个地区下属县、区及1个直管县共66个县、区35~64岁已婚农村妇女进行妇科检查及宫颈病变筛查,细胞学检查阳性者行阴道镜检查,阴道镜检查结果怀疑宫颈病变的多点组织活检行病理学检查。收集各监测点上报数据,应用SPSS 22.0软件进行统计学分析。结果 2015—2017年河北省运用贝塞斯达系统(the Bethesda system, TBS)分类的描述性报告的比例分别为95.26%、95.23%和96.66%。阴道镜异常检出率从2015年的19.62%(2 040例)下降到2017年的17.45%(1 968例)(χ^(2)=16.84,P<0.001),组织病理学异常检出率由2015年的26.87%(588例)上升至2017年的38.41%(822例)(χ^(2)=65.56,P<0.001)。宫颈癌前病变检出率由2015年的75.27/10万逐年提高到2017年105.91/10万(χ^(2)=23.86,P<0.001)。宫颈浸润癌检出率由2015年的17.28/10万上升至2017年的21.07/10万(χ^(2)=2.77,P=0.251),早期诊断率由2015年84.94%逐年增至2017年的86.80%(χ^(2)=0.57,P=0.751)。结论河北省宫颈癌筛查项目达到一定的筛查目的及效果,尤其是癌前病变筛查方面,但是在阴道镜和组织病理学检查方面仍需优化,技术有待提高。

Objective To analyze the data of rural women’s cervical disease screening project in Hebei Province from 2015-2017,and to evaluate the implementation condition of the project.Methods Gynecological examination and cervical cytology examination were conducted on married women aged 35-64 years in rural regions of 66 prefectures/counties during 2015-2017.Colposcopy was performed among the examinees with abnormal cervical cytology and multiple biopsy was subsequently carried out among the examinees with suspicious cervical lesions.We collected the data onto each monitoring point.SPSS 22.0 system software has used for statistical analysis.Results From 2015 to 2017,the proportion of descriptive reports using tthe Bethesda system(TBS)classification in Hebei Province was 95.26%,95.23%and 96.66%,respectively.The abnormal detection rate of colposcopy discreased from 19.62%(n=2040)in 2015 to 17.45%(n=1968)in 2017(χ^(2)=16.84,P<0.001).The abnormality rate of histopathology increased from 26.87%(n=588)in 2015 to 38.41%(n=822)in 2017(χ^(2)=65.56,P<0.001).The detection rate of cervical precancerous lesions increased from 75.27/100000 in 2015 to 105.91/100000 in 2017(χ^(2)=23.86,P<0.001).The detection rate of cervical invasive cancer increased from 17.28/100000 in 2015 to 21.07/100000 in 2017(χ^(2)=2.77,P=0.251).The early diagnosis rate increased from 84.94%in 2015 to 86.80%in 2017(χ^(2)=0.57,P=0.751).Conclusions The cervical cancer screening project of Hebei Province has achieved certain screening effect,especially in the screening of precancerous lesions.However,the quality of colposcope and histopathology need to be optimized.