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宫癌查指南建议从21岁开始每3年进行细胞检查,或从30岁开始每3-5年进行细胞检查,高风险人乳头瘤病毒 (hrHPV) 检测或联合检测. 不建议对21岁以下或65岁以上的妇女进行查.

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科学领域:

  • 癌症学
  • 预防医学
  • 公共卫生

背景情况:

  • 由于查, 子宫癌死亡人数有所下降.
  • 美国预防服务工作组 (USPSTF) 更新了2012年的建议.
  • 审查了查方法和间隔的证据.

研究的目的:

  • 更新USPSTF关于宫癌查的建议
  • 评估查策略,包括高危人乳头瘤病毒 (hrHPV) 检测和细胞检测.
  • 确定最佳的查年龄,间隔,并比较益处和危害.

主要方法:

  • 临床试验和队列研究的系统审查.
  • 用单独的HRHPV检测,单独的细胞检测或联合检测进行查的评估.
  • 对选参数和策略的决策分析建模.

主要成果:

  • 查可降低21至65岁女性的宫癌发病率和死亡率.
  • 对于21至65岁的妇女来说,查的好处超过了危害.
  • 对单独细胞学 (21-29年) 和细胞学,HPV或联合测试 (30-65年) 的益处超过危害的高度确定性.

结论:

  • 建议每3年对21-29岁的女性进行一次细胞检查.
  • 建议每3年进行一次细胞检查,每5年进行一次 hrHPV 检查,或每5年进行一次联合检查.
  • 建议不对21岁以下,65岁以上 (经过适当的查) 或没有高度病变史的子宫切除术后妇女进行查.