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目的:评价基层医生采用醋酸/碘试验在农村地区筛查宫颈癌及宫颈癌前期病变的效果。方法:以新疆和田县30～59岁已婚妇女作为对象,进行以人群为基础的子宫颈癌筛查,用5%醋酸染色后肉眼观察(VIA)和2%碘染色后肉眼观察(VIA),结果异常者进行阴道镜活检病理诊断。筛查妇女进行基本信息调查。采用同样的程序对人群进行复查,对比第1年,第2年的筛查及随访结果,评价该方案的效果。结果:2007～2009年总筛查人数5 565人,2007～2008年和田县巴格期镇筛查3565人,2008～2009年和田县洛浦镇筛查2 000人。巴格期镇第一轮筛查CINⅠ检出率为0.16%,CINⅡ0.14%,CINⅢ0.53%,宫颈癌0.22%;第二轮筛查(复查)CINⅠ检出率为0.20%,CINⅡ0.17%,CINⅢ0.13%,宫颈癌检出率为0。洛浦县第一轮筛查:ClNⅠ检出率0.6%,CINⅡ0.15%,ClNⅢ0.4%,宫颈癌0.45%;第二轮筛查ClNⅠ0.33%,CINⅡ0.11%,CINⅢ0.16%,宫颈癌检出率为0,筛查CINⅡ以上总阳性率1.24%。不同县两轮筛查中均第一年发现癌症,第二年没有,第一轮筛查CINⅡ以上的比率分别为82.00%(巴格期镇)和81.40%(洛浦县)。在查出的宫颈病变及宫颈癌的平均年龄分别CINⅠ42岁,CINⅡ43岁,CINⅢ45岁,宫颈癌45岁。结论:VIA/VILI方法短时间内易掌握、费用低、操作简单、出结果快,不依赖于仪器设备,在和田宫颈癌筛查中的到了良好的效果,发现的阳性患者给予及时治疗,在降低宫颈癌死亡率方面也有一定作用,可以在农村地区推广应用。
OBJECTIVE: To evaluate the efficacy of primary care physicians screening for cervical cancer and precancerous lesions of cervical cancer in rural areas using acetic acid / iodine test. Methods: A population-based cervical cancer screening was conducted in 30- 59-year-old married women in Hotan County, Xinjiang Uygur Autonomous Region. VIA and 2% Results of abnormal colposcopy biopsy pathological diagnosis. Screening women for basic information survey. The same procedure was used to review the population, comparing the screening and follow-up results of the first year and the second year to evaluate the effect of the program. Results: The total number of screening was 5 565 from 2007 to 2009, 3565 from Baghdad town of Hotan county from 2007 to 2008, and 2000 from Luopu town of Hotan county from 2008 to 2009. In the first round of screening in Baghdad, the detection rate of CINⅠwas 0.16%, CINⅡ0.14%, CINⅢ0.53% and cervical cancer 0.22%. The detection rate of CINⅠin the second round of screening was 0.20% and CINⅡ0. 17%, CINⅢ0.13%, cervical cancer detection rate of 0. The first round of screening Luopu County: ClN Ⅰ detection rate of 0.6%, CIN Ⅱ 0.15%, ClN Ⅲ 0.4%, cervical cancer 0.45%; the second round of screening ClN Ⅰ 0.33%, CIN Ⅱ 0.11%, CIN Ⅲ 0.16% , The detection rate of cervical cancer is 0, and the total positive rate of CINⅡ screening is 1.24%. Cancer was detected in the first round of screening in different counties in the first year but not in the second year, with 82.00% (Baghdad) and 81.40% (Luopu) of the first round of screening, respectively. In the detection of cervical lesions and cervical cancer, the average age were CIN Ⅰ 42 years old, CIN Ⅱ 43 years old, CIN Ⅲ 45 years old, 45 years old cervical cancer. Conclusion: The VIA / VILI method is easy to grasp in a short time, the cost is low, the operation is simple, the result is fast, and does not depend on the equipment. The VIA / VILI method has achieved good results in the screening of the Hetian cervical cancer. Reduce the mortality rate of cervical cancer also has a certain role, can promote the application in rural areas.