重复查结果对子宫癌风险产生负面影响
Philip E Castle1,2, Brian Befano3,4, Marianne Hyer4
1Division of Cancer Prevention, U.S. National Cancer Institute, Rockville, MD, USA.
Journal of the National Cancer Institute
|November 3, 2025
概括
用HPV检测进行宫癌查,如果反复出现负面结果,其效率就会降低. 建议使用较长的查间隔,特别是在人类乳头瘤病毒 (HPV) 检测结果呈阴性后.
科学领域:
- 妇科 妇科 妇科 妇科
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 与未知史相比,已知负面查史的子宫癌风险较低.
- 以前的研究结果表明,如果先前进行负面查,风险会降低.
- 这项研究扩展了这些发现,以评估多个负面结果后的查性能.
研究的目的:
- 用人类乳头瘤病毒 (HPV) 和细胞学联合测试评估三年一次宫癌查的效率.
- 评估在重复负面的共同测试结果后查性能如何变化.
- 根据查史,为宫癌查间隔提供建议.
主要方法:
- 对大约170万年龄在30-64岁之间的女性 (2003-2021) 三年HPV和细胞学联合测试数据的分析.
- 对3级+ (CIN3+) 的宫内皮质瘤和侵袭性宫癌的5年风险建模.
- 使用后勤-韦布尔流行-发病率模型来估计初始和随后的负面查后的风险.
主要成果:
- 与细胞学不同的是,HPV测试阳性度随着连续的查回合而下降.
- 对于CIN3+和侵袭性宫癌的诊断产量随着每一轮查显著下降.
- 第一个屏幕检测到8倍更多的CIN3+和癌症比第五个屏幕在四个连续的负面后.
- 在首次负面查后,CIN3+的五年风险大幅下降,随后下降幅度较小.
- 癌症风险仅在第一次查后才显著下降.
结论:
- 包含HPV测试的三年一次宫癌查表明,在一个或多个负结果后,效率下降.
- 这些发现支持实施延长查间隔,特别是对于有负面查测试史的人来说.
- 根据先前的结果优化查频率可以提高宫癌检测程序的效率.
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