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      Effectiveness of cervical cancer screening among rural women in Xinjiang Uygur Autonomous Region, 2015 – 2016

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          Abstract

          Objective To evaluate implementation effectiveness of cervical cancer screening in Xinjiang Uygur Autonomous Region (Xinjiang) for optimizing cervical cancer screening programs.

          Methods We extracted and analyzed the data on cervical cancer screening among 438 712 women in rural Xinjiang during 2015 and 2016 from National Cervical and Breast Cancer Screening Information Reporting System.

          Results Among the 227 509 and 211 203 women participating cervical cancer screening in 2015 and 2016, the detection rate of cervical intraepithelial neoplasia grade II and above (CIN II+) was 134.06/100 000 (305 cases) and 145.83/100 000 (308 cases); the positive rate of cytology inspection was 3.61% and 5.62%; the abnormal rate of colposcopy examination was 37.47% and 32.13%; the human papillomavirus (HPV) positive rate was 7.52% and 6.66%; there were significant between year differences in the positive rate of cytology inspection ( P < 0.001), HPV detection ( P = 0.001), and abnormal rate of colposcopy examination ( P < 0.001). Significant regional differences in prevalence rate of cervical cancer and precancerosis were observed ( P < 0.001) and the rates were higher among the women in southern Xinjiang compared to those in northern and eastern Xinjiang; there were also significant regional differences in prevalence rates of common gynecological diseases such as trichomonas and bacterial vaginitis ( P < 0.001), with higher rates among the women in northern Xinjiang. The detection rate of CIN II+ was 0.09%, 0.14%, and 0.21% for the screening with conventional pap smear, thin-prep cytology test (TCT) and HPV preliminary screening, respectively and HPV preliminary screening is superior to other two methods.

          Conclusion Certain progress was made in cervical cancer screening program in Xinjiang; thin-prep cytology test performed by well trained medical professionals at grassroots could be adopted in screening program and HPV preliminary screening is an optimal method for cervical cancer screening in the region.

          Abstract

          【摘 要】 目的 评价新疆维吾尔族自治区宫颈癌及乳腺癌检查项目(以下简称两癌项目)中宫颈癌筛查的实施效果,为国家两癌项目的优化提供依据。 方法 利用全国重大公共卫生项目两癌检查项目信息直报系统,对 2015 — 2016 年新疆 438 712 名农村妇女宫颈癌检查上报数据进行分析。 结果 2015 和 2016 年分别完成 227 509 和 211 203 名妇女的宫颈癌筛查任务,分别检出 305 例(134.06/10 万)、308 例(145.83/10 万)中度及以上宫颈上皮内瘤样病变(CIN2+);细胞学阳性率分别为 3.61 %和 5.62 %( P < 0.001);阴道镜异常率分别为 37.47 %和 32.13 %( P < 0.001);人乳头瘤病毒(HPV)阳性率分别为 7.52 %和 6.66 %( P = 0.001)。根据新疆不同地区进行分层发现,新疆南、北、东疆 3 地区间宫颈癌及癌前病变现患率有统计学差异( P < 0.001),以南疆妇女患病率较高;3 地区间常见妇科疾病包括滴虫性、细菌性阴道炎等现患率差异也具有统计学意义( P < 0.001),以北疆妇女患病率较高。常规巴氏涂片法、液基细胞学检测(TCT)及 HPV 初筛法对宫颈上皮内瘤样病变 II 级及以上病变者(≥ CIN2+)的检出率分别为 0.09 %、 0.14 %和 0.21 %,HPV 初筛法优于 TCT 或常规巴氏涂片法初筛效果。 结论 宫颈癌筛查项目在新疆地区取得了一定成效。只有对基层医生充分培训的高质量 TCT 可以作为筛查方案,HPV 初筛可以作为新疆地区宫颈癌筛查的优选方法。

          Author and article information

          Journal
          CPH
          Chinese Journal of Public Health
          Chinese Journal of Public Health (China )
          1001-0580
          01 May 2019
          30 November 2018
          : 35
          : 5
          : 583-586
          Affiliations
          [1] 1Department of Research Management, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830012, China
          Author notes
          *Corresponding author: Zhou Jianlin, E-mail: 35891194@ 123456qq.com
          Article
          zgggws1120481
          10.11847/zgggws1120481
          af261eec-2c54-4541-9f10-dc409deb15f3
          © 2019 China Public Health Editorial Department

          This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

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          Categories
          Journal Article

          Medicine,Nutrition & Dietetics,Occupational & Environmental medicine,Health & Social care,Infectious disease & Microbiology,Public health
          Xinjiang Uygur Autonomous Region,screening,cervical cancer

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