Page 51 - 中国全科医学2022-18

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【Abstract】 Background The results of cervical cancer containment have demonstrated regional differences in
China，which may be due to various socioeconomic and cultural developments across regions. Understanding cervical cancer
screening results in various regions is of a great significance for developing effective cervical cancer prevention strategies.
Objective To perform a comparative analysis of the results of two yearly cervical cancer screening（2019 and 2020） in urban
areas of Shihezi，Xinjiang，to estimate the changes in high-risk human papillomavirus （hrHPV） infection and cervical lesion
detection rate in women. Methods A retrospective design was used. Participants were 46 994 women from Shihezi urban areas
who underwent initial cervical cancer screening with an HPV test〔underwent once either between December 2018 and December
2019（the 2019 yearly screening） or between January and June 2020（the 2020 yearly screening）〕 in Shihezi Maternal and
Child Health Hospital，Shihezi People's Hospital，and First Affiliated Hospital，School of Medicine，Shihezi University during
December 2018 to June 2020. Data of the screening results，including HPV infection rate and subtypes，Thinprep cytologic test
results，and pathological diagnosis of cervical biopsy samples taken during a colposcopy were collected，and those of the 2019
yearly screening were compared with those of 2020 yearly screening. Results There were 18 378，and 28 616 attendees for
2019，and 2020 yearly screenings，respectively，and 44 746 of them finally completed the screening. The completion rate of
cervical cancer screening in 2020 was higher than that in 2019 〔97.07% （27 779/28 616） vs （16 967/18 378）〕 （P<0.05）.
A total of 5 992 cases （12.75%） were detected with HPV infection，among them，the prevalence of HPV 16 and HPV 18 was
18.55%（1 112/5 992），and that of other HPV subtypes was 81.45%（4 880/5 992）. The prevalence of HPV infections in
participants of 2020 yearly screening〔11.09%（3 176/28 616）〕was lower than that in participants of 2019 yearly screening
〔15.32%（2 816/18 378）〕（P<0.05）. The prevalence of single-type HPV infections in participants of 2019 yearly screening
was higher than that in participants of 2020 yearly screening 〔11.38%（2 092/18 378） vs 7.45%（2 674/28 616）〕（P<0.05）.
The prevalence of multi-type HPV infections in participants of 2019 yearly screening was higher than that in participants of
2020 yearly screening〔3.94%（724/18 378） vs 1.75%（502/28 616）〕（P<0.05）. The prevalence of HPV was 10.37%
（909/8 767），12.22%（1 916/15 677），13.71%（2 500/18 234） and 15.45%（667/4 316），respectively，in four age
groups of participants（30-39，40-49，50-59，and 60-65）in these two yearly screenings totally，showing an increase with
age（P<0.05）. The prevalence of HPV showed a decrease in 30-39-year-old participants，so did it in 40-49-year-old，
50-59-year-old，and 60-65-year-old participants of 2020 yearly screening （P<0.05）. The top 5 prevalent single HPV subtypes
found in 2019 yearly screening were HPV 52（20.84%），HPV 16（14.48%），HPV 53（8.56%），HPV 51（7.93%），
and HPV 39/68（7.60%），while those found in 2020 yearly screening were HPV 52（15.07%），HPV 16（12.64%），HPV
58（12.30%），HPV 53（10.25%） and HPV 66（4.75%）. HPV 18 ranked as the 11th most prevalent single HPV subtype in
both two screenings. The proportion of patients with pathological diagnosis of inflammation/condyloma and LSIL in cervical cancer
screening in 2020 was lower than that in 2019（P<0.05）. The 30-39-year-old participants of the 2020 yearly screening had lower
prevalence of inflammation/condyloma detected by colposcopy than did those of the 2019 yearly screening （47.83% vs 74.36%）
（P<0.05）. The 50-59-year-old participants of the 2020 yearly screening had lower prevalence of inflammation / condyloma
detected by colposcopy than did those of the 2019 yearly screening （65.50% vs 77.22%）（P<0.05）. The 30-39-year-old
participants of 2020 yearly screening had higher prevalence of colposcopy-detected low-grade squamous intraepithelial lesion
（LSIL） than did those of 2019 yearly screening（31.30% vs 5.13%）（P<0.05）. The 40-49-year-old participants of 2020
yearly screening had higher prevalence of colposcopy-detected LSIL than did those of 2019 yearly screening（27.06% vs 16.07%）
（P<0.05）. The 50-59-year-old participants of 2020 yearly screening had higher prevalence of colposcopy-detected LSIL
than did those of 2019 yearly screening（23.64% vs 8.89%） （P<0.05）. Conclusion The completion rate of cervical cancer
screening in 2020 was obviously better than that in 2019，but it still needs to be further improved. Compared with 2019，HPV
infection rate decreased，the major prevalent HPV subtypes changed，and LISL prevalence increased in 30-39 and 50-59 age
groups in 2020. Follow-up management is suggested to be strengthened in 30-39 and 50-59 age groups.
【Key words】 Uterine cervical neoplasms；Screening；Human papillomavirus；Colposcopy；Age distribution；
Women's health services

宫颈癌是威胁女性健康的生殖系统恶性肿瘤。最新 位；而且宫颈癌的发病率与死亡率在全球分布差距极大，
数据显示 2020 年全球宫颈癌新发病例 60.4 万，死亡病 发展中国家的发病率和死亡率分别是发达国家的 1.7 倍
例 34.2 万，在全球范围内 23 个国家的发病率居于女性 与 2.4 倍 ［1］ 。2020 年中国宫颈癌新发病例 11.0 万，死
恶性肿瘤首位，同时是 36 个国家的女性首位肿瘤死亡 亡病例 5.9 万，无论是新发病例数还是死亡例数，均仅
原因，无论发病率还是死亡率，均排全球女性肿瘤第 4 次于印度，是世界第二大宫颈癌疾病负担国家 ［2-3］ 。宫