Incidence and survival rate of women with cervical cancer in the Greater Amsterdam area.
Incidence and survival rate of women with cervical cancer in the Greater Amsterdam area.
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DOI：
10.1038/sj.bjc.6601157
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发表时间：
2003-09-01
影响因子：
8.8
通讯作者：
中科院分区：
文献类型：
--
作者：
为了评估以人群为基础的宫颈癌筛查对荷兰宫颈癌发生的影响，我们调查了大阿姆斯特丹地区癌症登记处登记的宫颈癌发病率和生存率。鳞状细胞癌的发病率从1988年的9.2/10万下降到2000年的5.9/10万（P<0.001）。腺癌的发病率保持稳定。在调整年龄、分期和淋巴结累及后，腺癌患者的相对死亡风险是鳞状细胞癌患者的1.6倍（95% CI 1.2-2.1）。生存率的降低与组织学类型有关，因为在校正混杂因素后效果仍然显著。随着时间的推移，女性鳞状细胞癌的预后显著改善。诊断为腺癌的女性没有观察到明显的变化。这些结果表明，荷兰在大阿姆斯特丹地区实施的筛查项目与鳞状细胞癌患者发病率降低和生存率提高有关，但未能检测到腺癌（前）恶性病变。由于超过92%的腺癌及其前体含有高危HPV，因此在细胞学筛查中加入HPV检测可能会改善目前的筛查方案，以检测腺癌及其前体病变。
To evaluate the effect of population-based cervical cancer screening on the occurrence of cervical cancer in The Netherlands, we investigated the incidence and survival of cervical cancer registered by a cancer registry in the Greater Amsterdam area. The incidence rate of squamous cell carcinoma decreased significantly from 9.2/100 000 women in 1988 to 5.9/100 000 in 2000 (P<0.001). The incidence rate of adenocarcinomas remained stable. After adjustment for age, stage and lymph node involvement, the relative risk of death was 1.6 times higher for patients with adenocarcinomas than for patients with squamous cell carcinoma (95% CI 1.2–2.1). The decreased survival was related to histological type, as the effect remained significant after correction for confounding factors. Over time, the prognosis of women with squamous cell carcinoma improved significantly. No significant change was observed for women diagnosed with adenocarcinoma. These results suggest that the screening programme in The Netherlands as executed in the Greater Amsterdam area is associated with a decreased incidence and increased survival of patients with squamous cell carcinoma, but fails to detect (pre)malignant lesions of adenocarcinoma. Since more than 92% of adenocarcinomas and its precursors contain high-risk HPV, adding HPV testing to cytologic screening might improve the present screening programme in detecting adenocarcinoma and its precursor lesions.
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影响因子：
13.6
作者：
Hemminki, K;Li, XJ;Mutanen, P
通讯作者：
Mutanen, P
影响因子：
8.4
作者：
Andersson, S;Rylander, E;Wilander, E
通讯作者：
Wilander, E
影响因子：
6.4
作者：
SIGURDSSON, K
通讯作者：
SIGURDSSON, K
DOI：
10.1046/j.1525-1438.2001.011001024.x
发表时间：
2001-01-01
影响因子：
4.8
作者：
Liu, S;Semenciw, R;Mao, Y
通讯作者：
Mao, Y
DOI：
10.1046/j.1525-1438.2001.011001039.x
发表时间：
2001-01-01
影响因子：
4.8
作者：
Pilch, H;Günzel, S;Knapstein, PG
通讯作者：
Knapstein, PG