Practice Bulletin No. 168: Cervical Cancer Screening and Prevention.
Practice Bulletin No. 168: Cervical Cancer Screening and Prevention.
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DOI：
10.1097/aog.0000000000001708
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发表时间：
2016-10-01
影响因子：
7.2
通讯作者：
中科院分区：
文献类型：
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在过去的30年里，由于广泛的筛查，美国宫颈癌的发病率下降了50%以上。1975年，这一比率为每10万名妇女14.8人。到2011年，这一比例降至每100 000名妇女6.7人。该疾病的死亡率也经历了类似的下降，从1975年的每100，000名女性中5.55人下降到2011年的每100，000名女性中2.3人（1）。美国癌症协会（ACS）估计，2015年美国将有12，900例宫颈癌新发病例，4，100例死于该疾病（2）。宫颈癌在全球范围内更为常见，特别是在没有筛查计划的国家，估计每年有527，624例新发病例和265，672例死亡。当宫颈癌筛查项目被引入社区时，宫颈癌的发病率明显降低（4，5）。宫颈癌筛查的新技术不断发展，管理结果的建议也在不断发展。此外，对于不同年龄的女性，有不同的风险-收益考虑因素，这反映在特定年龄的筛查建议中。2011年，ACS，美国阴道镜检查和宫颈病理学会（ASCCP）和美国临床病理学会（ASCP）更新了宫颈癌筛查的联合指南（6），美国预防服务工作组（USPSTF）也是如此（7）。随后，在2015年，ASCCP和妇科肿瘤学会（SGO）发布了使用人乳头瘤病毒（HPV）检测进行宫颈癌初筛的临时指南，该指南于2014年获得美国食品和药物管理局（FDA）批准（8）。本文件的目的是提供有关预防和早期发现宫颈癌的最佳可用证据的审查。
The incidence of cervical cancer in the United States has decreased more than 50% in the past 30 years because of widespread screening. In 1975, the rate was 14.8 per 100,000 women. By 2011, it decreased to 6.7 per 100,000 women. Mortality from the disease has undergone a similar decrease from 5.55 per 100,000 women in 1975 to 2.3 per 100,000 women in 2011 (1). The American Cancer Society (ACS) estimated that there would be 12,900 new cases of cervical cancer in the United States in 2015, with 4,100 deaths from the disease (2). Cervical cancer is much more common worldwide, particularly in countries without screening programs, with an estimated 527,624 new cases of the disease and 265,672 resultant deaths each year (3). When cervical cancer screening programs have been introduced into communities, marked reductions in cervical cancer incidence have followed (4, 5).New technologies for cervical cancer screening continue to evolve, as do recommendations for managing the results. In addition, there are different risk-benefit considerations for women at different ages, as reflected in age-specific screening recommendations. In 2011, the ACS, the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American Society for Clinical Pathology (ASCP) updated their joint guidelines for cervical cancer screening (6), as did the U.S. Preventive Services Task Force (USPSTF) (7). Subsequently, in 2015, ASCCP and the Society of Gynecologic Oncology (SGO) issued interim guidance for the use of a human papillomavirus (HPV) test for primary screening for cervical cancer that was approved in 2014 by the U.S. Food and Drug Administration (FDA) (8). The purpose of this document is to provide a review of the best available evidence regarding the prevention and early detection of cervical cancer.