Comparative analysis of characteristics of women with cervical cancer in high- versus low-incidence regions
Comparative analysis of characteristics of women with cervical cancer in high- versus low-incidence regions
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DOI：
10.1016/j.ygyno.2004.06.005
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发表时间：
2004-09-01
影响因子：
4.7
通讯作者：
Thompson, C
中科院分区：
文献类型：
--
作者：
Liu, JH;Rose, B;Thompson, C
目标。找出可能有助于解释中国南部浸润性宫颈癌发病率明显高于澳大利亚的特定特征。从1999年到2001年共招募了185名宫颈癌患者：106名来自广州和长沙(中国南部)，79名来自悉尼(澳大利亚东南部)。通过问卷调查获得人口学和危险因素信息；从医院病历中提取临床病理数据。通过聚合酶链式反应、直接测序和/或Amplicor(TM)杂交法确定癌组织中人乳头瘤病毒(HPV)的状态。中国人的平均年龄明显低于澳大利亚人(44岁对53岁)，尽管首次性行为的平均年龄相似。澳大利亚女性更有可能吸烟，报告有多个性伴侣，并有性传播疾病史(但没有生殖器疣)。然而，他们受过更好的教育，更频繁地使用屏障避孕措施，并且更有可能在确诊前报告定期巴氏涂片检查。中国人肿瘤的HPV阳性率(83%)低于澳大利亚肿瘤(90%)；但HPV16和18型在两个人群中都是最常见的基因型别(59%和77%)，且主要见于年轻女性的癌症。HPV58或59型在12例(14%)中国人中扩增，而在1例澳大利亚人癌中扩增。宫颈癌不仅在中国更常见，而且比澳大利亚更年轻。虽然在一些危险因素上观察到了显著的差异，但中国南部地区参加宫颈筛查的比例要低得多，这可能是最严重的后果。(C)2004 Elsevier Inc.保留所有权利。
Objective. To identify particular characteristics that might help explain the markedly higher rate of invasive cervical cancer in southern China as compared with Australia.Methods. One hundred eighty-five women with cervical cancer were recruited between 1999 and 2001: 106 from Guangzhou and Changsha (southern China), and 79 from Sydney (southeast Australia). Demographic and risk factor information was obtained by questionnaire; clinicopathologic data were extracted from hospital records. The human papillomavirus (HPV) status of cancer biopsies was ascertained by consensus PCR assays, direct sequencing and/or Amplicor(TM) hybridisation.Results. The mean age of the Chinese was significantly lower than the Australians (44 versus 53 years), although mean age at first sexual intercourse was similar. Australian women were more likely to smoke, to report multiple sexual partners and to have a history of sexually transmitted diseases (but not of genital warts). However, they were better educated, were more frequent users of barrier contraception and were far more likely to report regular Pap smears before diagnosis. The HPV positivity rate of Chinese cancers (83%) was less than Australian tumours (90%); but HPV 16 and 18 were the most common genotypes in both populations (59% and 77%), and predominated in cancers from younger women. HPV types 58 or 59 were amplified from 12 (14%) of the Chinese but from only one Australian cancer.Conclusions. Cervical cancer is not only more common in China but also develops at a younger age than in Australia. While significant differences in some risk factors were observed, the much lower participation in cervical screening in southern China is likely to be of greatest consequence. (C) 2004 Elsevier Inc. All rights reserved.