■中国政府已采取行动,通过实施全国农村地区宫颈癌筛查计划(NACCSPRA)来预防宫颈癌,它于2009年推出。大量研究表明,长期宫颈癌筛查会改变人乳头瘤病毒(HPV)的感染率和宫颈疾病的检测。在过去的10年中,有近8000万女性接受了筛查,占目标人口的30%;然而,在一些农村地区,如内蒙古自治区鄂尔多斯市,山西省祥源县,和Jin云县,浙江省景宁县,预防和治疗宫颈癌的计划已经实施。大量研究表明,长期宫颈癌筛查会改变人乳头瘤病毒(HPV)感染和宫颈疾病检测的发生率。在这项研究中,我们的目的是确定高危型HPV(hrHPV)的感染率和宫颈病变的检出率;以及与宫颈癌相关因素的变化,提供科学数据,为农村地区消除宫颈癌的努力提供信息。
■这是一个横截面,以人口为基础,和多中心调查。来自中国三个农村地区的人口(内蒙古自治区鄂尔多斯市,山西省祥源县,和浙江省Jin云县和景宁县)被选中,并邀请9,332名20-64岁的妇女通过细胞学和HPV检测参加宫颈癌筛查。评估的结果是:hrHPV感染率,HPV16、18、16/18和其他12种hrHPV类型(HPV31、33、35、39、45、51、52、56、58、59、66和68);细胞学和组织学病变的检出率;以及与HPV感染相关的因素。
■共有9,217名年龄45.62±8.02岁的女性被纳入本研究。hrHPV感染率,HPV16、18、16/18等12种hrHPV类型占16.3%,3.0%,1.5%,4.3%,和13.6%,分别。不同年龄HPV感染率差异有统计学意义(P<0.05)。hrHPV感染率,16、18、16/18和其他12种hrHPV类型显示单峰感染模式,高峰年龄为56-65岁。年龄,婚姻状况,活产婴儿的数量,教育水平,生殖疾病史,饮酒史是hrHPV感染的危险因素.研究中细胞学异常的检出率为12.98%,年龄大于56岁的女性更高。宫颈上皮内瘤变N2+和N3+在人群中的检出率分别为1.45%和0.77%,分别。CIN2+和CIN3+的最高发病率分别为32.12%和17.51%,分别,在41-45岁组。
■hrHPV感染率,我们的筛查人群中的HPV16和宫颈病变低于中国农村地区的平均水平。hrHPV感染率,HPV16、18和16/18显示单峰感染模式,感染的高峰年龄为56-65岁。hrHPV感染的危险因素是年龄,饮酒史,婚姻状况,生殖疾病,教育水平,以及活产婴儿的数量。基于这些数据,我们建议对农村地区30岁以上的女性进行宫颈癌筛查,尤其是41-45岁的人。
UNASSIGNED: The Chinese government has taken action to prevent cervical cancer by implementing the National Cervical Cancer Screening Programme in Rural Areas (NACCSPRA), which was launched in 2009. Numerous studies have demonstrated that long-term cervical cancer screening alters human papillomavirus (HPV) infection rates and cervical disease detection. Nearly 80 million women have been screened over 10 years, representing <30% of the target population; however, in some rural areas, such as Ordos City of Inner Mongolia Autonomous Region, Xiangyuan County of Shanxi Province, and Jinyun County, and Jingning County of Zhejiang Province, programs for prevention and treatment of cervical cancer have been implemented. Numerous studies have demonstrated that long-term cervical cancer screening alters rates of human papillomavirus (HPV) infection and cervical disease detection. In this
study, we aimed to determine the infection rates of high-risk HPV (hrHPV) and the detection rate of cervical lesions; and changes in factors associated with cervical cancer, to provide scientific data to inform efforts to eliminate cervical cancer in rural areas.
UNASSIGNED: This was a cross-sectional, population-based, and multi-center survey. Populations from three rural areas of China (Ordos City of Inner Mongolia Autonomous Region, Xiangyuan County of Shanxi Province, and Jinyun County and Jingning County of Zhejiang Province) were selected and 9,332 women aged 20-64 years old were invited to participate in cervical cancer screening by both cytology and HPV testing. The outcomes assessed were: infection rates with hrHPV, HPV16, 18, 16/18, and other 12 hrHPV types (HPV 31,33,35,39,45,51,52,56,58,59,66 and 68); detection rates of cytological and histological lesions; and factors associated with HPV infection.
UNASSIGNED: A total of 9,217 women aged 45.62 ± 8.02 years were included in this
study. Infection rates with hrHPV, HPV 16, 18, 16/18, and other 12 hrHPV types were 16.3%, 3.0%, 1.5%, 4.3%, and 13.6%, respectively. There were significant differences among the age-specific HPV infection rates (P < 0.05). Infection rates with hrHPV, 16, 18, 16/18, and the other 12 hrHPV types showed a single peak infection mode, with a peak age of 56-65 years old. Age, marital status, number of live births, education level, reproductive disease history, and a history of alcohol consumption were risk factors for hrHPV infection. The detection rate of cytological abnormalities was 12.98% in the
study and was higher in women older than 56 years old. The detection rates of cervical intraepithelial neoplasia CIN2+ and CIN3+ in the population were 1.45% and 0.77%, respectively. The highest incidence rates of CIN2+ and CIN3+ were 32.12% and 17.51%, respectively, in the 41-45 years old group.
UNASSIGNED: Infection rates with hrHPV, HPV16, and cervical lesions among our screening population were lower than the mean level in rural areas of China. Infection rates with hrHPV, HPV16, 18, and 16/18 showed a single-peak infection pattern, with the peak age of infection being 56-65 years old. Risk factors for hrHPV infection were age, history of alcohol consumption, marital status, reproductive diseases, education level, and the number of live births. Based on these data, we recommend that cervical cancer screening be offered to women older than 30 years in rural areas, particularly those aged 41-45 years.