在芬兰宫癌查计划中,高风险的人类乳头瘤病毒与细胞学查两轮:基于人口的队列研究
Iiris Juulia Turunen1,2, Ilkka Kalliala1,3, Maiju Pankakoski2
1Department of Obstetrics and Gynaecology, Helsinki University Hospital, Helsinki, Finland.
BMJ medicine
|October 10, 2025
概括
高风险人乳头瘤病毒 (hrHPV) 查比细胞学查更有效,可以更早地检测宫癌前病变. hrHPV查是安全有效的,在特定子组中可能需要更长的查间隔.
科学领域:
- 妇科瘤学 妇科瘤学
- 公共卫生 公共卫生
- 查计划 查计划
背景情况:
- 子宫癌查计划旨在早期检测癌前病变.
- 细胞学查 (巴氏涂抹) 是标准的,但高危人乳头瘤病毒 (hrHPV) 测试提供了潜在的改善.
- 在例行计划中比较hrHPV和细胞学查对于优化宫癌预防至关重要.
研究的目的:
- 为了比较常规高风险人类乳头瘤病毒 (hrHPV) 查与细胞学查在宫癌预防中的有效性.
- 评估2级或更高 (CIN2+) 的宫内皮质瘤的检测率和两轮查中的结肠镜转诊率.
- 评估hrHPV查的安全性和有效性,在一个成熟的国家查计划中进行查.
主要方法:
- 基于人口的队列研究使用芬兰大规模查注册表 (2012-2022) 的数据进行.
- 1,180,491名妇女参加了细胞学或基于HRHPV的宫癌查.
- 结果包括出席率,阳性测试结果,肠镜转诊和因人口因素而调整后的CIN2+发病率.
主要成果:
- 与细胞学查 (0.98%和0.35%分别) 相比,hrHPV查导致显著更高的肠镜转诊率 (3.37%) 和CIN2+检测率 (0.92%) .
- 与第一轮 (3.54%和0.98%) 相比,第二轮 hrHPV 查显示了转诊率 (2.42%) 和 CIN2+ 检测率 (0.38%) 的降低.
- 细胞学查没有显示转诊或CIN2+发现在轮次之间减少. 在第一轮的负 hrHPV 测试与第二轮的 CIN2+ 风险非常低 (0.2%).
结论:
- 常规的hrHPV查是有效和安全的,比细胞学查更早地识别癌前病变.
- 该研究表明,每隔五年对 hrHPV 的查间隔是适当的.
- 对于特定的子组,可以考虑较长的查间隔,例如具有负 hrHPV 测试的女性或50岁及以上的女性,以优化资源配置和患者管理.
相关概念视频
01:20Comparing the Survival Analysis of Two or More Groups
553
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
553
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
406
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
406