65岁及以上妇女的追赶HPV测试的价值:丹麦基于人口的非随机干预研究
Mette Tranberg1, Lone Kjeld Petersen2,3, Anne Hammer4,5
1University Research Clinic for Cancer Screening, Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.
PLoS medicine
|July 6, 2023
概括
在65-69岁的女性中,高风险的人类乳头瘤病毒 (HPV) 检测显著增加了检测2级或更严重的宫内皮质瘤 (CIN2+) 的可能性. 这一发现支持向老年妇女提供HPV检测,以改善宫癌的预防.
科学领域:
- 妇科 妇科医生 妇科
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 高风险人乳头瘤病毒 (HPV) 检测为宫癌查提供了比细胞学更高的灵敏度.
- 65岁及以上的女性约占宫癌死亡人数的50%,但通常不包括在HPV查计划中.
- 这项研究解决了在没有先前HPV测试记录的老年女性HPV查方面的差距.
研究的目的:
- 评估追赶HPV测试对65-69岁女性2级或更严重 (CIN2+) 宫内皮质瘤检测的影响.
- 评估HPV查对这一年龄组标准护理的益处危害比.
主要方法:
- 一项基于人口的准实验性研究,涉及65-69岁的丹麦妇女,没有最近的宫癌查史.
- 干预组 (n=11,192) 接受了HPV测试 (临床或自取样) 的提议.
- 参考组 (n=33,387) 接受了标准的护理 (如果因其他原因寻求护理,则有机会进行细胞学).
主要成果:
- 与参考组相比,干预组的CIN2+检测率显著更高 (1000人中3.9人),比基准组的0.3人中高.
- 干预组中62.2%的符合条件的妇女在12个月内接受了HPV查.
- 检测一个CIN2+病例所需的结肠镜检查次数在两组之间是相似的 (11.6对10.1).
结论:
- 在65-69岁的女性中,补充HPV测试显著增加了CIN2+病变的检测.
- 这些发现表明,向从未接受过查的老年妇女提供HPV检测可以加强宫癌预防工作.
- 这项研究有助于关于将65岁及以上的妇女纳入HPV查协议的持续讨论.
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