Analysis of the results of 3034 cases of cervical cancer screening in Chun'an county / 中国基层医药

ABSTRACT

Objective:To understand the screening of cervical cancer in our county and provide epidemiological data for the prevention and control of cervical cancer.Methods:A total of 3 034 healthy women with 30~65 years old in Chun'an county were recruited in this prospective study from June 2015 to January 2016.All of the subjects received cervical cancer screening.The respondents were randomly divided into non-typeable HPV screening group (2018 cases) and the vision inspection with acetic acid and visual inspection with Lugol's iodine screen (VIA/VILI) group (1016 cases). Direct colposcopy or VIA/VILI visual examination was performed for those with positive HPV, and then colposcopy was performed for those with positive visual examination.The suspicious lesions tissues were applied for pathology detection.From September 2017 to February 2018, 2 363 patients who were initially negative received VIA/VILI combined with unclassified HPV examination, and those who were positive received colposcopy and pathological biopsy.The positive rate of primary screening and cervical squamous intraepithelial neoplasia disorders level 2 and above (CIN Ⅱ + ) lesion detection rate were analyzed in the two-stage screening.Results:From June 2015 to January 2016, the preliminary screening positive rate of unclassified HPV group was 11.60% (234/2 018). A total of 150 patients with positive results were recalled for colposcopy, with a recall rate of 64.10% (150/234). Among the 150 cases, 119 cases (79.33%) were positive in the unclassified HPV preliminary screening, and 31 cases (20.66%) were positive in VIA/VILI examination after HPV preliminary screening.The positive rate of VIA/VILI initial screening group was 20.28% (206/1 016), and the recall rate of colposcopy was 99.51% (205/206). A total of 108 cases underwent colposcopy with abnormal pathological biopsy examination in the two groups, and the pathological biopsy rate was 30.34% (108/356), and the pathologic biopsy CIN Ⅱ+ lesion detection rate was 297/100 000 (9/3 034). In the second round of screening from September 2017 to February 2018, 2 363 subjects were recruited back to the baseline, with a recall rate of 77.89% (2 363/3 034). In the 2 363 cases, the early screen VIA/VILI anomalies or HPV positive early screening positive rate was 17.01% (402/2 363), and the colposcopy examination the recall rate was 80.10% (322/402), and 80 cases received vaginal lens suspicious pathological biopsy, the pathological biopsy rate was 24.84% (80/322), the pathological results showed that CIN Ⅱ+ detection rate of 296/100 000 (7/2 363).Conclusion:The detection rate of precancerous suspicious lesions in cervical cancer screening in our county is lower than the national average level.On the one hand, we should strengthen the propaganda and education of active screening, improve the compliance and cooperation degree of screening objects, and improve the recall rate of suspicious cases.On the other hand, the government should invest more efforts to select the screening technology with high sensitivity, improve the screening technology of doctors at the basic screening point, and improve the detection rate of cervical cancer prelesions.