2016—2020年内蒙古鄂尔多斯市35~64岁女性宫颈癌筛查结果及危险因素分析

Screening Results and Risk Factors of Cervical Cancer Among Women Aged 35~64 Years Old in Ordos of Inner Mongolia,2016―2020

[目的]掌握鄂尔多斯市女性高危型人乳头瘤病毒(high-risk human papillomavirus,hrHPV)感染情况和宫颈癌及癌前病变检出情况,并探讨宫颈癌及癌前病变的危险因素。[方法]数据来源于鄂尔多斯市2016―2020年开展的宫颈癌筛查项目。分析35~64岁女性的hrHPV感染率和宫颈癌及癌前病变检出率情况。同时以825例宫颈上皮内瘤样病变2级以上(CIN2+)为病例组,按照年龄不超过2岁从同旗区同年参与筛查未被诊断为CIN2+的女性中选取825例对照,分析宫颈癌及癌前病变的危险因素。[结果]研究纳入187 863名女性进行分析,hrHPV感染率为12.81%,hrHPV感染率随年龄增大而增加(线性趋势χ2=155.787,P<0.001)。宫颈癌检出率为37.79/10万,宫颈癌癌前病变检出率为401.36/10万,早诊率为93.45%,宫颈癌癌前病变和宫颈癌检出率分别在40~44岁和60~64岁年龄组最高,不同年龄组间差异有统计学意义(P值均<0.001)。影响因素分析结果显示hrHPV感染为宫颈癌及癌前病变发生的危险因素(OR=374.442,95%CI:90.718~1 545.534),而受教育程度高(OR=0.251,95%CI:0.092~0.683)为保护因素。[结论]鄂尔多斯市宫颈癌癌前病变、宫颈癌检出率及早诊率较高,显示出鄂尔多斯宫颈癌筛查工作成效显著。未来开展工作时,应格外注重40~44岁女性的筛查,以实现早诊早治的目的;积极鼓励适龄女性及早接种HPV疫苗;加强对女性,特别是低文化程度以及老年女性宫颈癌相关知识的宣传教育,提升其健康意识,促使其主动参与宫颈癌筛查。

[Purpose]To investigate the current situation of high-risk human papillomavirus(hrHPV)infection and cervical lesions in Ordos from 2016 to 2020 and to analyze the risk factors of cervi-cal cancer and precancerous lesions.[Methods]Data from the cervical cancer screening program conducted in Ordos from 2016 to 2020 were analyzed.The prevalence of hrHPV and the detection rates of cervical cancer and precancerous lesions in women aged 35~64 years old were analyzed.In addition,825 cases of cervical intraepithelial neoplasia grade 2 or worse(CIN2+)were selected as the case group,and 825 controls were selected from women in the same area who participated in screening in the same year and were not diagnosed with CIN 2+and were within 2 years of age to analyze the risk factors of cervical cancer and precancerous lesions.[Results]187863 women were included for analysis,and the hrHPV positive rate was 12.81%,increasing with age(linear trendχ2=155.787,P<0.001).The detection rate of cervical cancer was 37.79/105,the detection rate of precancerous cervical lesions was 401.36/105,and the early diagnosis rate was 93.45%.The de-tection rates of precancerous cervical lesions and cervical cancer were highest in the age groups of 40~44 and 60~64 years old,respectively,with statistically significant differences between age groups(all P values<0.001).The main risk factors for CIN2+were hrHPV infection(OR=374.442,95%CI:90.718~1545.534),and college education level was a protective factor(OR=0.251,95%CI:0.092~0.683).[Conclusion]The detection rates of cervical precancerous lesions and cervical cancer and early diagnosis are relatively high,indicating that the cervical cancer screening program in Ordos has achieved significant results.Extra attention should be paid to women aged 40 to 44 years old to achieve early diagnosis and treatment.It is also necessary to encourage women to receive HPV vaccination early,and carry out targeted health education of cervical cancer knowledge for women,especially those with low levels of education and older age,to enhance their health awareness and inspire initiative in their cervical cancer screening.