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Abstract：
BACKGROUND: Cytological screening remains a high-impact practice, particularly in low-resource settings, for preventing cervical cancer. The examination of screening practices over time and the prevalence of epithelial abnormalities have not been investigated in longitudinal studies in one of the largest countries in the Middle East and Africa.
METHODS: Routine healthcare data, between March 1981 and December 2022, were extracted from the database of the Early Cancer Detection Unit in a tertiary referral university hospital in the Greater Cairo Region, Egypt. Cervical smears were obtained using a standardized technique and sent to the cytopathology laboratory for conventional cytology examination by expert pathologists. The anonymous data were analyzed to determine the temporal trend of the number of women screened each year and the prevalence of epithelial abnormalities.
RESULTS: Data included the results of satisfactory smears from 95120 women. The mean age (SD) of the women at the time of screening was 38.5 (10.5). None of the included women received an HPV vaccine. Abnormal epithelial cells were reported in 5174 women (5.44%). Of these epithelial abnormalities, the majority were low-grade squamous intraepithelial lesions in 4144 women (4.36%). Other abnormalities included atypical squamous cells in 378 women (0.40%), high-grade squamous intraepithelial lesions in 226 women (0.24%), atypical glandular cells not otherwise specified in 184 women (0.19%), adenocarcinoma in 165 women (0.17%), squamous cell carcinoma in 70 women (0.07%), and atypical glandular cells favoring neoplasms in 7 women (0.01%). Women who were at an early age at first intercourse, those who opted for routine cervical cytology screening, and those who were older at screening were more likely to have epithelial abnormalities. The yearly number of screened women was positively associated with the detection of low-grade squamous intraepithelial lesions (correlation coefficient [95% CI] = 0.84 [0.72, 0.91]) and negatively associated with the detection of squamous cell carcinoma (correlation coefficient [95% CI] = -0.55 [-0.73, -0.29]).
CONCLUSIONS: The small number of annually screened Egyptian women and the temporal trend in epithelial abnormalities critically demonstrate the need for establishing and scaling up a structured population-based program to achieve the goal of eliminating cervical cancer.
METHODS: Routine healthcare data, between March 1981 and December 2022, were extracted from the database of the Early Cancer Detection Unit in a tertiary referral university hospital in the Greater Cairo Region, Egypt. Cervical smears were obtained using a standardized technique and sent to the cytopathology laboratory for conventional cytology examination by expert pathologists. The anonymous data were analyzed to determine the temporal trend of the number of women screened each year and the prevalence of epithelial abnormalities.
RESULTS: Data included the results of satisfactory smears from 95120 women. The mean age (SD) of the women at the time of screening was 38.5 (10.5). None of the included women received an HPV vaccine. Abnormal epithelial cells were reported in 5174 women (5.44%). Of these epithelial abnormalities, the majority were low-grade squamous intraepithelial lesions in 4144 women (4.36%). Other abnormalities included atypical squamous cells in 378 women (0.40%), high-grade squamous intraepithelial lesions in 226 women (0.24%), atypical glandular cells not otherwise specified in 184 women (0.19%), adenocarcinoma in 165 women (0.17%), squamous cell carcinoma in 70 women (0.07%), and atypical glandular cells favoring neoplasms in 7 women (0.01%). Women who were at an early age at first intercourse, those who opted for routine cervical cytology screening, and those who were older at screening were more likely to have epithelial abnormalities. The yearly number of screened women was positively associated with the detection of low-grade squamous intraepithelial lesions (correlation coefficient [95% CI] = 0.84 [0.72, 0.91]) and negatively associated with the detection of squamous cell carcinoma (correlation coefficient [95% CI] = -0.55 [-0.73, -0.29]).
CONCLUSIONS: The small number of annually screened Egyptian women and the temporal trend in epithelial abnormalities critically demonstrate the need for establishing and scaling up a structured population-based program to achieve the goal of eliminating cervical cancer.
摘要：
背景：细胞学筛查仍然是一种高影响力的实践，特别是在低资源环境中，预防宫颈癌。在中东和非洲最大的国家之一的纵向研究中，尚未对随时间推移的筛查实践和上皮异常的患病率进行调查。
方法：常规医疗保健数据，在1981年3月至2022年12月之间，是从大开罗地区三级转诊大学医院的早期癌症检测部门的数据库中提取的，埃及。使用标准化技术获得宫颈涂片，并由专家病理学家送至细胞病理学实验室进行常规细胞学检查。对匿名数据进行分析，以确定每年筛查的女性人数的时间趋势以及上皮异常的患病率。
结果：数据包括95120名妇女满意的涂片结果。筛查时妇女的平均年龄（SD）为38.5（10.5）。纳入的女性均未接受HPV疫苗。5174名妇女（5.44％）报告了上皮细胞异常。在这些上皮异常中，4144名女性(4.36%)中大多数为低度鳞状上皮内病变.其他异常包括378名妇女的非典型鳞状细胞（0.40％），226名妇女（0.24％）的高级别鳞状上皮内病变，184名女性（0.19%）未另外指定的非典型腺细胞，165名女性的腺癌（0.17％），70名女性鳞状细胞癌（0.07%），和非典型腺细胞有利于7名女性（0.01％）的肿瘤。第一次性交时年龄很小的女性，那些选择常规宫颈细胞学筛查的人，筛查时年龄较大的患者更有可能出现上皮异常.每年筛查的女性人数与低级别鳞状上皮内病变的检测呈正相关（相关系数[95%CI]=0.84[0.72,0.91]），与鳞状细胞癌的检测呈负相关（相关系数[95%CI]=-0.55[-0.73,-0.29]）。
结论：每年接受筛查的埃及妇女人数较少，上皮异常的时间趋势严重表明，有必要建立和扩大基于人群的结构化计划，以实现消除宫颈癌的目标。
方法：常规医疗保健数据，在1981年3月至2022年12月之间，是从大开罗地区三级转诊大学医院的早期癌症检测部门的数据库中提取的，埃及。使用标准化技术获得宫颈涂片，并由专家病理学家送至细胞病理学实验室进行常规细胞学检查。对匿名数据进行分析，以确定每年筛查的女性人数的时间趋势以及上皮异常的患病率。
结果：数据包括95120名妇女满意的涂片结果。筛查时妇女的平均年龄（SD）为38.5（10.5）。纳入的女性均未接受HPV疫苗。5174名妇女（5.44％）报告了上皮细胞异常。在这些上皮异常中，4144名女性(4.36%)中大多数为低度鳞状上皮内病变.其他异常包括378名妇女的非典型鳞状细胞（0.40％），226名妇女（0.24％）的高级别鳞状上皮内病变，184名女性（0.19%）未另外指定的非典型腺细胞，165名女性的腺癌（0.17％），70名女性鳞状细胞癌（0.07%），和非典型腺细胞有利于7名女性（0.01％）的肿瘤。第一次性交时年龄很小的女性，那些选择常规宫颈细胞学筛查的人，筛查时年龄较大的患者更有可能出现上皮异常.每年筛查的女性人数与低级别鳞状上皮内病变的检测呈正相关（相关系数[95%CI]=0.84[0.72,0.91]），与鳞状细胞癌的检测呈负相关（相关系数[95%CI]=-0.55[-0.73,-0.29]）。
结论：每年接受筛查的埃及妇女人数较少，上皮异常的时间趋势严重表明，有必要建立和扩大基于人群的结构化计划，以实现消除宫颈癌的目标。
