新疆维吾尔族女性宫颈癌终身一次筛查适宜起始年龄研究

发布时间：2018-01-19 02:36

本文关键词： 宫颈肿瘤筛查年龄 Markov链维吾尔族　出处：《中国全科医学》2017年14期 　论文类型：期刊论文

【摘要】：背景新疆维吾尔族女性宫颈癌发病率及死亡率高于全国平均水平,且有不同于汉族的发病特点,其发病年龄明显早于汉族。在实施人乳头瘤病毒(HPV)DNA筛查过程中发现部分维吾尔族女性仅终身筛查一次的现状。目的对宫颈癌终身一次HPV DNA筛查的不同起始年龄筛查方案进行研究,探讨在新疆维吾尔族女性开展宫颈癌筛查的适宜起始年龄。方法采用2013—2016年收集的现场调查和参考文献数据,模拟一个10万人的新疆维吾尔族女性队列,基于Markov模型的基本原理,在自然史的基础上结合宫颈癌筛查方案,构建Markov模型。根据既往研究获得相关参数,代入Markov模型,以1年为循环周期,通过多次循环运算,预测以30、35、40、45岁为筛查起始年龄女性接受终身一次筛查的发病例数、死亡例数。结果筛查起始年龄为30、35、40、45岁的筛查方案宫颈癌的发病例数分别为967、1 005、1 027、1 044例,死亡例数分别为9、11、13、10例,与自然人群比较,发病率分别降低70.66%、69.51%、68.84%、68.32%,死亡率分别降低70.00%、63.33%、56.67%、66.67%。敏感性分析结果显示,HPV DNA灵敏度、覆盖率取不同的参数时,最优的筛查适宜起始年龄均为30岁,Markov模型具有较好的稳定性。结论以30岁为新疆维吾尔族女性宫颈癌终身一次HPV DNA筛查的起始年龄,可有效降低宫颈癌的发病率和死亡率。
[Abstract]:Background the incidence and mortality rate of cervical cancer among Uygur women in Xinjiang is higher than the national average, and it is different from the Han nationality. Its onset age was significantly earlier than that of the Han nationality. In the course of DNA screening, some Uygur women were found to have only one lifetime screening. Objective to study the different age screening programs of HPV DNA screening for cervical cancer. To explore the appropriate age of starting cervical cancer screening for Uygur women in Xinjiang. Methods the field survey and reference data collected from 2013 to 2016 were used. Simulation of a 100,000 Xinjiang Uygur women cohort, based on the basic principles of the Markov model, on the basis of natural history combined with cervical cancer screening program. The Markov model was constructed. According to the previous studies, the relevant parameters were obtained, and then the Markov model was substituted into the Markov model. The number of cases and deaths of women who underwent lifelong screening at 45 years of age. Results the age of starting screening was 30 to 35 / 40. The number of cervical cancer cases in the 45-year-old screening program was 967 / 1 005 / 1 027 / 1 044, respectively, and the number of deaths was 9 / 11 / 13 / 13 / 10 respectively, which was compared with that of the natural population. The incidence of the disease was reduced by 70.66 and 69.51, respectively. The mortality rate was reduced by 68.32and the mortality rate was reduced by 70.00and 63.3356.67%, respectively. The sensitivity analysis showed that the optimal screening age was 30 years old when the coverage rate was different. Conclusion 30 years old is the starting age of HPV DNA screening for cervical cancer in Xinjiang Uygur women. Can effectively reduce the incidence and mortality of cervical cancer.
【作者单位】：石河子大学医学院预防医学系;
【基金】：新疆生产建设兵团博士基金专项(2013BB015)
【分类号】：R737.33
【正文快照】： 宫颈癌是常见的妇科恶性肿瘤之一,在世界范围女性恶性肿瘤中,其发病率居第3位,在发展中国家和地区尤为常见,甚至居第1位[1-3]。中国2012年宫颈癌发病率为62/10万,死亡率为30/10万[4]。新疆宫颈癌的发病率和死亡率高于全国平均水平,而维吾尔族女性的发病率及死亡率远高于本地区

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