EFFECT OF ORGANIZED SCREENING ON THE RISK OF CERVICAL-CANCER - EVALUATION OF SCREENING ACTIVITY IN ICELAND, 1964-1991
EFFECT OF ORGANIZED SCREENING ON THE RISK OF CERVICAL-CANCER - EVALUATION OF SCREENING ACTIVITY IN ICELAND, 1964-1991
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DOI：
10.1002/ijc.2910540408
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发表时间：
1993-06-19
影响因子：
6.4
通讯作者：
SIGURDSSON, K
中科院分区：
文献类型：
--
作者：
SIGURDSSON, K
冰岛癌症协会于1964年6月发起了一项宫颈癌筛查方案。目的是通过每隔2至3年对2S-69岁年龄组进行筛查，降低发病率和死亡率。本报告分析了浸润性和浸润前疾病的趋势以及分期和组织学分布，并评估了就诊率、目标年龄组和筛查间隔。在筛查之前，发病率和死亡率都在上升，但此后两者都显着下降。筛查大大影响了微侵袭和分期大于或等于11个鳞状细胞癌的发生率，但对腺鳞癌和腺鳞癌的发生率没有影响。检测到浸润性癌症的平均年龄显著下降，在69岁以上的正确筛查对象中几乎不存在癌症。1980年后，在年轻女性中，首次就诊时中度和重度浸润前病变的发生率显著增加。这些病变的发生率在第一次正常就诊后仅1年就相当高。它的结论是，有组织的筛查，配合自发活动，是有效地降低宫颈癌的风险。定期的高出勤率和对异常病例的严格随访是良好筛查结果的先决条件。筛查最好从20岁左右开始，并延长到60-69岁，这取决于该年龄的阴性涂片数量。筛查可以安全地从2至3年的筛查间隔开始，但在老年人中，这一间隔可能会延长至4或5年。(C)1993 Wiley-Liss，Inc.
The Icelandic Cancer Society launched a screening programme for cervical cancer in June 1964. The aim was to lower the incidence and mortality rates by screening the age group 2S-69 at 2- to 3-year intervals. This report analyses the trends in invasive and pre-invasive disease and the distribution of stage and histology, and also evaluates the attendance, the target age group and the screening interval. Before screening, the incidence and mortality rates were on the increase but both have since fallen significantly. Screening greatly affected the rate of microinvasive and stage greater-than-or-equal-to 11 squamous-cell carcinomas but not the rate of adeno- and adenosquamous carcinoma. The mean age at detection of invasive cancer has decreased significantly and cancer has become practically non-existent among correctly screened subjects over the age of 69. Among younger women the rates of moderate and severe pre-invasive lesions at first visit increased significantly after 1980. The rate of these lesions was fairly consistently high only 1 year after the first normal visit. It is concluded that organized screening, coordinated with spontaneous activity, is effective in reducing the risk of cervical cancer. Regular high attendance and strict follow-up of abnormal cases is a prerequisite for good screening results. Screening should preferably start at about the age of 20 and extend to 60-69 years of age, depending on the number of negative smears by that age. Screening can safely start with a screening interval of 2 to 3 years, but this interval can probably be extended to 4 or 5 years at older ages. (C) 1993 Wiley-Liss, Inc.