Opportunistic screening for cervical cancer in elderly women aged≥65 years
10.3760/cma.j.issn.1674-0815.2019.05.007
- VernacularTitle:65岁及以上老年女性宫颈癌机会性筛查的价值
- Author:
Ping SUN
1
;
Zhijian XU
;
Kai ZHANG
;
Jinghua ZUO
;
Xiaowei ZHAO
;
Jiaqin HUANG
Author Information
1. 国家癌症中心中国医学科学院北京协和医学院肿瘤医院防癌科100021
- Keywords:
Uterine cervical neoplasms;
Aged;
Opportunistic screening;
Elderly women aged 65 years old and over;
Cervical liquid-based cytology;
Human papilloma virus
- From:
Chinese Journal of Health Management
2019;13(5):411-415
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the role and significance of opportunistic screening in cervical cancer screening for elderly women aged≥65 years old. Methods The screening data of 1 304 elderly women (≥65 years old) who underwent opportunistic screening for cervical cancer at the Cancer Hospital, Chinese Academy of Medical Sciences, between January 1, 2010, and December 31 st, 2018, were analyzed retrospectively. Women who underwent cervical cytology tests and human papillomavirus (HPV) testing were divided into two groups according to age as following 65-69 and ≥70 years old. Women with abnormal cytology or who were hrHPV-positive were followed up. The cervical cytological abnormalities and high-risk HPV infection rates in women aged≥65 years in opportunistic screening were analyzed. Results Of all cases, 175 had abnormal cytology or were hrHPV-positive. Among the 1 304 women, 69 were TCT-positive, with a positivity rate of 5.3%, including 17 cases (24.6%) of high-degree squamous intraepithelial neoplasia and 3 cases (4.4%) of squamous cell carcinoma. The total abnormality rate of TCT in the 65-to 69-year age group (6.7%, 43 cases) was significantly higher than that in the≥70 age group (3.9%, 26 cases), and the difference was statistically significant between the two groups (P=0.024). The overall prevalence of hrHPV infection was 10.7% (139/1 304). HPV58 (31/174, 17.9%) was identified as the most common high-risk HPV type, followed by HPV16, HPV52, HPV33, and HPV31. Follow-up showed that 50.3% of the women had never been screened in the past 10 years, and no statistically significant difference in TCT abnormality and hrHPV infection positivity rate were found between those who had been screened (80 cases) and those who had not been screened at least once in 5 years (87 cases) (P>0.05). Conclusion Attention should be paid to the screening for cervical cancer in elderly women aged ≥65 years old. Opportunistic screening is a supplement to the population-based organized cervical cancer screening. The termination age of cervical cancer screening for elderly women may be appropriately extended.
