成都市农村妇女两癌筛查现状及影响因素研究

Analysis of the results of two-cancer screening and related factors among rural women in Chengdu

目的:分析成都市35~64岁农村妇女乳腺癌和宫颈癌(简称两癌)筛查现状及影响因素,为农村适龄妇女两癌的防控提供参考。方法:对辖区内35~64岁的农村适龄妇女进行免费两癌筛查。乳腺癌筛查进行乳腺的视诊、触诊和彩超检查;宫颈癌筛查包括妇科检查、宫颈细胞学检查、阴道镜检查和组织病理学检查。对检查结果及影响因素进行统计分析。结果:本次筛查对象平均年龄(48.9±6.5)岁。乳腺超声BIRADS分级显示,3级占7.1%,4级占1.4%。宫颈细胞学异常率为8.9%,阴道镜检查异常率为22.0%,病理活检宫颈癌检出率为76.6/10万,癌前病变检出率为919.0/10万。多因素Logistic回归分析显示:年龄(OR=0.895,95%CI 0.842~0.953)是乳腺BI-RADS分级评分高级别的保护因素(P<0.05),既往做过乳腺手术或活检(OR=2.884,95%CI 1.305~6.375)、乳房结节(OR=2.536,95%CI 1.638~3.926)、乳房团块(OR=8.383,95%CI 1.929~36.435)、乳房肿块(OR=8.092,95%CI 2.116~30.945)是乳腺BI-RADS分级评分高级别的危险因素(均P<0.05),绝经(OR=0.697,95%CI 0.529~0.918)、避孕套避孕(OR=0.625,95%CI 0.434~0.900)是宫颈细胞学检查异常的保护因素(均P<0.05)。结论:农村妇女免费两癌筛查中,应将35~49岁年龄段,既往做过乳腺手术或活检,乳腺体检中发现乳房结节、乳房团块、乳房肿块,未绝经妇女、未使用避孕套避孕等妇女,作为重点关注对象,达到早发现、早诊断、早治疗的目的,改善农村妇女健康水平。

Objective:To provide evidence for prevention and control of cervical cancer and breast cancer(short for the two-cancers)in rural women aged at 35 to 64 years via investigating their current status of screening and influencing factors.Methods:Free screening for the two-cancers were conducted for the rural women aged at 35 to 64 years old in the district.The breast cancer screening involves visual inspection,palpation,and ultrasound color doppler of the breast.Cervical cancer screening includes gynecological examination,cervical cytology,colposcopy,and histopathology examinations.Statistical analyses were performed to analyze the influencing factors of the results of those screening tests.Results:The average age of the screened women was(48.9±6.5)years old.As for the breast cancer,women with BI-RADS grade-3 and grade-4 measured via breast ultrasonography consisted of 7.1%and 1.4%of all participants,respectively.As for the screening results of the cervical cancer,8.9%participants had abnormal cervical cytology,and 22%of women who underwent colposcopy test had abnormal results.The detection rate of cervical cancer and precancerous lesions using pathological biopsy was 76.6/100000,and 919.0/100000,respectively.Results from the multivariate Logistic regression analyses showed that age(OR=0.895,95%CI 0.842-0.953)was a protective factor for BI-RADS grading score(P<0.05),and having undergone breast surgery or biopsy(OR=2.884,95%CI 1.305-6.375),having breast nodules(OR=2.536,95%CI 1.638-3.926),having breast lumps(OR=8.383,95%CI 1.929-36.435),and having breast mass(OR=8.092,95%CI 2.116-30.945)are risk factors for higher-grade BI-RADS score(P<0.05).Menopause(OR=0.697,95%CI 0.529-0.918)and condom contraception(OR=0.625,95%CI 0.434-0.900)were protective factors for abnormal cervical cytology(P<0.05).Conclusion:Women who were 35-49 years old,have undergone breast surgery or biopsy,had breast nodules,breast lumps,or breast lumps,were premenopausal,or had not used condoms for contraception should be focused on in the two-cancers screening in rural women.This will help with early detection,early diagnosis,and early treatment of the two-cancers,and improve the health level of rural women.