Effectiveness of cervical cancer screening over cervical cancer mortality among Japanese women
Effectiveness of cervical cancer screening over cervical cancer mortality among Japanese women
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DOI：
10.1093/jjco/hyl060
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发表时间：
2006-08-01
影响因子：
2.4
通讯作者：
Tamakoshi, Akiko
中科院分区：
文献类型：
--
作者：
Aklimunnessa, Khandoker;Mori, Mitsuru;Tamakoshi, Akiko
背景资料：各种研究表明，在发达国家，宫颈癌（CC）筛查显著降低了CC的发病率和死亡率。虽然日本于1982年开始在全国范围内对30岁以上的女性进行每年一次的CC筛查，但CC筛查对CC死亡率的有效性尚未通过任何前瞻性队列研究进行评估。因此，本研究评估了CC死亡率与自我报告的CC筛选和其他一些因素的全国性cohort study.Methods：基线调查的日本协作队列研究的受试者的招募完成在1988-90年，并遵循到2003年。这项研究只分析了63541名妇女，年龄30-79岁，谁是免费的任何癌症histors.Results：在随访期间，38 CC死亡。平均死亡年龄为67.0岁，死亡率为4.2/10万人-年。CC筛查参与率为46.9%。校正后的考克斯模型显示，由于CC筛选，CC死亡率显著降低[风险比（HR）= 0.30，95%置信区间（CI）= 0.12-0.74]。当调整年龄、体重指数和分娩次数时，保护性几乎保持不变（HR = 0.30，95%CI = 0.12-0.76）。结果还显示，CC筛选可以减少至少50%的CC死亡，即使排除可能的自我选择bias.Conclusions的影响：CC筛选在日本可能会降低CC死亡率显着为30-79岁的妇女。然而，需要进一步研究更多的CC死亡和增加统计能力来验证这些发现。
Background: Various studies have revealed that cervical cancer (CC) screening significantly reduces both CC incidence and mortality in developed countries. Although Japan introduced a nationwide government funded annual CC screening for the women aged 30+ in 1982, the effectiveness of CC screening on CC mortality has not yet been evaluated by any prospective cohort study. Therefore, the present study evaluated the association of CC mortality with self-reported CC screening and some other factors by a nationwide cohort study.Methods: Baseline survey of the Japan Collaborative Cohort Study for the enrollment of subjects was completed during 1988-90 and followed until 2003. This study only analyzed 63 541 women, aged 30-79 years, who were free from any cancer history at enrollment.Results: During the follow-up period, 38 CC deaths were identified. The mean age at mortality was 67.0 years, with a mortality rate of 4.2 per 100 000 person-years. Participation rate in CC screening was 46.9%. Age-adjusted Cox model indicated significantly lower CC mortality [hazard ratio (HR) = 0.30, 95% confidence interval (CI) = 0.12-0.74] due to CC screening. Protectiveness remained almost the same (HR = 0.30, 95% CI = 0.12-0.76) when adjusted for age, body mass index and number of deliveries. The results also revealed that CC screening could reduce at least 50% of CC deaths even after excluding the effect of possible self-selection bias.Conclusions: CC screening in Japan may reduce CC mortality significantly for women aged 30-79 years. However, further studies with more CC deaths and increased statistical power are needed to validate the findings.