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目的通过新疆和田地区策勒县宫颈癌的流行病学调查结果,探讨降低宫颈癌发病率和病死率的有效措施。方法2003-07-2004-07,以新疆策勒县城及各乡镇周边村的已婚妇女为调查对象,进行问卷调查、妇科检查及宫颈涂片,凡宫颈涂片为非典型细胞以上者在阴道镜下行宫颈活检。结果共调查8020例,其中资料完整可供统计者7971例。发现宫颈癌患者42例,发病率527/10万。平原及山区发病率分别为436/10万及844/10万。宫颈癌发病率随着年龄的增加而增高。单因素Logistic回归统计分析结果显示,早婚、早孕、早产、多孕、多婚次及宫颈糜烂为宫颈癌的危险因素。多因素Logistic回归分析显示,初婚年龄≤16岁的妇女患宫颈癌的危险是≥18岁的3·54倍(OR=3·54,95%CI1·26~9·93),P<0·05。宫颈糜烂Ⅱ度者患宫颈癌的危险性是正常宫颈者的5·17倍(OR=5·170,95%CI1·71~15·59),P<0·01;宫颈糜烂Ⅲ度者是11·95倍(OR=11·95,95%CI2·14~66·53),P<0·01。结论新疆策勒县是宫颈癌高发区,应在该地区对30岁以上的女性定期行宫颈涂片检查。早婚及宫颈糜烂是该地区宫颈癌发病的主要危险因素。
Objective To investigate the epidemiological results of cervical cancer in Cele County, Hotan region of Xinjiang, and to explore effective measures to reduce the incidence and mortality of cervical cancer. Methods From July 2003 to July 2004, the married women in Cele county and surrounding villages of Xinjiang were investigated. Questionnaires, gynecological examinations and cervical smears were carried out. All those with cervical smear atypical cells in the vagina Cervical biopsy under the microscope. Results A total of 8020 cases were investigated, of which 7971 cases were complete with statistics. 42 cases of cervical cancer found, the incidence rate of 527/100000. Plains and mountainous areas were 436 / 100,000 and 844 / 100,000 respectively. Cervical cancer incidence increases with age. Logistic regression analysis showed that early marriage, early pregnancy, premature delivery, multiple pregnancies, multiple weddings and cervical erosion were the risk factors of cervical cancer. Multivariate logistic regression analysis showed that the risk of cervical cancer in first marriage age≤16 years old was 3.54 times higher than that of 18 years old (OR = 3.44, 95% CI 1.26-9.33), P <0. 05. Cervical erosion Ⅱ degree of risk of cervical cancer are normal cervix 5 · 17 times (OR = 5 · 170,95% CI1 · 71 ~ 15 · 59), P <0.01; cervical erosion Ⅲ degree is 11.95 times (OR = 11.95, 95% CI2.14 ~ 66.53), P <0.01. Conclusions Celle County in Xinjiang is a high incidence of cervical cancer. Cervical smears should be regularly examined in women over the age of 30 in this area. Early marriage and cervical erosion are the major risk factors for cervical cancer in the area.