Age-restricted cervical screening: HPV testing at age 50 identifies a high risk group for cervical disease
Age-restricted cervical screening: HPV testing at age 50 identifies a high risk group for cervical disease
复制标题
DOI：
10.1046/j.1525-1438.2002.01116.x
复制
发表时间：
2002-11-01
影响因子：
4.8
通讯作者：
Kitchener, HC
中科院分区：
文献类型：
--
作者：
Cruickshank, ME;Chambers, G;Kitchener, HC
目前正在考虑修改子宫颈检查的现行年龄政策。我们进行了一项回顾性配对病例对照研究和成本分析研究，以确定50岁后出现异常涂片的风险因素，并确定年龄限制性宫颈筛查对筛查计划年度成本的影响。来自11岁出生队列的所有妇女（229名）在50岁或以上时出现异常涂片，与两个阴性涂片对照组年龄匹配。在48岁至52岁之间进行的常规筛查涂片进行了人乳头瘤病毒（HPV）亚型16和18的检测。流行病学资料通过邮寄问卷收集。评估了HPV检测和年龄限制筛查政策下的费用变化。我们发现HPV 16状态是50岁以后细胞学异常的唯一独立显著危险因素，比值比为10.26（95%CI 1.25-84.11）。在HPV检测的基础上，在50岁时提前退出筛查的政策将产生净成本节省。这些发现表明，HPV检测可能是一种有价值的手段，可以识别50岁后仍有风险的一小部分妇女，并释放医疗资源。
Changes to the present age policy of cervical screening are currently under consideration. We conducted a retrospective matched case-control study and cost analysis study to identify risk factors for the development of an abnormal smear after age 50 and to determine the impact of age-restricted cervical screening on the annual cost of the screening program. All women (229) from an 11-year birth cohort who developed an abnormal smear at age 50 or over were age-matched for two controls with negative smears. Routine screening smears taken between age 48 and 52 were tested for human papillomavirus (HPV) subtypes 16 and 18. Epidemiologic data were collected by postal questionnaire. Changes in costs under a policy of HPV testing and age-restricted screening were assessed. We found that HPV 16 status was the only independently significant risk factor for abnormal cytology after age 50 with an odds ratio of 10.26 (95% CI 1.25-84.11). A policy of early withdrawal from screening at age 50 on the basis of HPV testing would produce net cost savings. These findings suggest that HPV testing could be a valuable means of identifying the small proportion of women still at risk after 50, and of releasing health care resources.