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Objective:To analyze the relevant factors affecting the frequency and behavior of health check-up among the population of medical examinees.Methods:From January to June 2022, 491 health examinees who had health check-ups at the Second Affiliated Hospital of Shandong First Medical University were included.Basic information of the check-up population and their needs for check-up services (form of check-up, content of check-up, cost of check-up, form of feedback on check-up results, and needs for check-up providers) were obtained based on a questionnaire survey.According to the frequency of previous medical check-up, the examinees were divided into never-check-up group (frequency of check-up was 0, n=45), the irregular check-up group (the interval between two physical examinations >1 year, n=49) and the regular check-up group (frequency of check-up=1 year, n=347). The frequency of previous medical check-up was used as the dependent variable, and the age, gender, education level, income, form of medical check-up and cost of medical check-up were used as independent variables to analyse the relevant factors affecting the frequency of their medical check-ups.The above count data were analyzed by one-way analysis using chi-square test, and the count data with statistically significant differences in one-way analysis were analyzed by binary logistic regression.The statistical software was SPSS 21.0. Results:The study included 491 medical examinees, of which 9.16%(45/491) were in the never-check-up group, 20.16%(99/491) in the irregular check-up group and 70.68%(347/491) in the regular check-up group. The impact of demography characteristics of physical examinees on the frequency of health check-up, and there were statistically significant differences in the frequency of health check-up in terms of gender, job, education, and income ( χ2=21.826, 157.113, 104.764, 45.486, all P<0.05). The understanding of health check-up and the attention paid to one's own health were influencing factors that affected the frequency of health check-up. There were statistically significant differences in the frequency of health check-up in necessity of health check-up, attention to one's own health, health check-up forms, health check-up institutions, health check-up price and health check-up contents ( χ2=9.277, 25.863188.239, 59.115, 39.250, 28.314, all P<0.05). Logistic regression analysis showed gender, job type, monthly income, necessity of health check-up, concerns for items of check-up, forms and institutions of check-up were influencing factor of health check-up frequency(all P<0.05). Conclusion:The health check-up behavior of the population and the frequency of regular medical check-ups are influenced by the factors such as gender, education, occupation, income, form of medical check-up, price of medical check-up, choice of medical check-up institution and the degree of concern for one’s own health. The popularisation of health check-ups for special groups such as men, low-income people, low literacy and insufficient awareness of the importance of one’s own health will help improve the overall health awareness of the population.
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Objective To study the iodine nutrition status and analyze the detection of thyroid nodules and its related influencing factors in 450 health check-up residents in Chengdu area and to provide evidence for the prevention of thyroid nodules. Methods A total of 450 residents who underwent health check-up in the Western Theater General Hospital from January 2019 to January 2022 were selected as the research subjects. The gender, age, weight and other basic conditions of the subjects were investigated, and their urinary iodine levels and occurrence of thyroid nodules were examined. Univariate and multivariate methods were used to analyze the influencing factors of occurrence of thyroid nodules. Results The overall urinary iodine level of the 450 health check-up people in Chengdu area was (96.89 -212.38) μg/L, with an average of (164.86±42.58) μg/L. The urinary iodine level of males was significantly higher than that of females (P60 years old (P60 years old , people in rural areas and people with history of diabetes mellitus in the thyroid nodule group were higher than that in the non-thyroid nodule group, and thyroid stimulating hormone (TSH), thyroglobulin antibody (TGAb) and anti-thyroid peroxidase antibody (TPOAb) were higher than those in the non-thyroid nodule group (P60 years old, history of diabetes mellitus and high levels of TGAb and TPOAb were risk factors for the occurrence of thyroid nodules (P<0.05). Conclusion The overall iodine nutrition level of 450 health check-up people in Chengdu is in the appropriate range, and the detection rate of thyroid nodules is high. It is necessary to strengthen the examination of thyroid nodules in key populations (women , history of diabetes mellitus, the elderly, etc.), and provide early detection and active intervention to prevent the occurrence and progression of thyroid nodules.
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Welding operations are widely present in the manufacturing production process, involving a large number of occupational groups, and are the key occupations where work injuries and occupational diseases occur in China. For different welding processes and welding materials, the content and focus of occupational health monitoring are different. At present, the item of occupational health examination in welding operation is in poor consistency with the on-site exposure of occupational hazard factors, and it is mainly concentrated in the stage of disease development, which can not reflect the early health damage caused by welding dust exposure in time. The emergence of biomarkers of welding dust can make up for this defect. Therefore, it is of great significance to describe the current situation of occupational health monitoring of welding dust and summarize the research progress of related biomarkers for the early prevention of diseases caused by welding dust and the practice of occupational health monitoring.
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Occupational Health , Welding , Occupational Exposure/analysis , Dust/analysis , Biomarkers , Air Pollutants, Occupational/analysisABSTRACT
Objective To compare and validate the efficiency of four models predicting the malignancy of solitary pulmonary nodules (SPN). Methods Patients diagnosed with SPN during health check-up were selected as the research subjects. Risk assessment was conducted using four predictive models. Outcomes were obtained through prospective follow-up. Statistical description and univariate analysis were performed for all risk factors of the four models. ROC curve was applied to compare the efficiency of the four predictive models. Results A total of 479 cases were included in this study. Among these patients, 82 were diagnosed with lung tumor, and the malignant rate was 17.12%. Age, nodule diameter, smoking, family history of tumor, history of extrapulmonary tumor ≥5 years, upper lobe site, unclear boundary, and spiculation rates were higher in the malignancy group than those in the benign group (P < 0.05). The efficiency of Brock model was the best. Its AUC was 0.833, sensitivity was 80.49%, and specificity was 74.31%. Its Youden index, positive likelihood ratio, positive predictive value, and negative predictive value were the highest, and its negative likelihood ratio was the lowest. The AUC, sensitivity, and specificity of Mayo model were 0.815, 81.71%, and 67.51%, respectively; those of PKUPH model were 0.754, 69.51%, and 73.55%, respectively; and those of VA model were 0.738, 68.29%, and 67.55%, respectively. Conclusion The Brock model might be the most appropriate predictive model for the risk assessment of SPN among the health check-up population, and the VA model is the worst. The combination of Brock, Mayo, and PKUPH models requires further study.
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Objective: Although oral health and skeletal muscle status are known to be risk factors for type 2 diabetes mellitus (T2DM), there is limited information on their combined effects among community-dwelling older adults. The purpose of this study was to investigate the association between oral health and skeletal muscle status among older adults with T2DM in Japan.Participants and Methods: This cross-sectional study included data from individuals aged ≥60 years. T2DM was defined as a glycosylated hemoglobin A1c level ≥48 mmol/mol (≥6.5%) or the use of hypoglycemic agents. For oral health status, dental hygienists assessed the number of teeth (NT) and masticatory function (MF). Skeletal muscle status was assessed using skeletal muscle mass index (SMI) and handgrip strength (HGS). Logistic regression analysis examined T2DM in nine-category combinations of oral health status (each of the three categories in NT and MF) and skeletal status (each of the three categories in SMI and HGS).Results: T2DM was prevalent in 83 participants (16.4%) and was significantly associated with low NT and SMI (odds ratio [OR] = 5.93, 95% confidence interval [CI]: 1.37–25.73) and low MF and SMI (OR = 4.48, 95% CI: 1.23–16.35) compared to high NT and SMI and high MF and SMI, respectively.Conclusion: Our findings indicate that low muscle mass with tooth loss or masticatory dysfunction is associated with T2DM among community-dwelling older adults. This suggests that maintaining oral health and muscle mass may be an effective strategy for the prevention of T2DM.
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OBJECTIVES@#After the Fukushima Daiichi nuclear power plant disaster in 2011, residents of Kawauchi village who experienced evacuation had a high risk of suffering from diabetes and metabolic syndrome compared with non-evacuees. In addition to evacuation, lifestyle characteristics can be important factors influencing the development and prognosis of diabetes or glucose tolerance. The current study aimed to evaluate the effects of evacuation (i.e., lifestyle changes) on the incidence of diabetes among the non-diabetic residents of Kawauchi village.@*METHODS@#Design is retrospective cohort study. Annual health examination data of residents of Kawauchi village and control area (Ono town) in Fukushima prefecture from 2008 to 2017, as available from the Japanese National Health Insurance system. Participants were classified into three groups: "Diabetes (DM)" (FBG ≥ 126 mg/dL or HbA1c ≥ 6.5% or hospital visit for DM or usage of diabetic medication), "Borderline DM" (126 mg/dL > FBG ≥ 110 mg/dL or 6.5% > HbA1c ≥ 6.0%, and without hospital visit, and without diabetic medication), and "Normoglycemic" (FBG < 110 mg/dL and HbA1c < 6.0%, and without hospital visit, and without diabetic medication). New onset of diabetes was evaluated and the events or missing data were occurred at health checkup. For this survival analysis, 339 residents in Kawauchi and 598 residents in Ono were included. Average follow-up periods after 2010 were 3.9 years in Kawauchi village and 3.6 years in Ono town.@*RESULTS@#Compared with the normoglycemic group, incidence of DM was much greater in the borderline DM group, where DM occurred among 38.2% of the group in 2012 and increased to over 60% cumulatively through 2017 in Kawauchi village. DM had a prevalence of 16.3% in 2012, and below 30% in 2017 in borderline DM group of Ono town. Cox proportional hazard regression analysis was applied to non-DM groups at both study sites separately to evaluate the effects of lifestyle changes at each site. While BMI, BMI change, and the lack of regular exercise (HR = 1.29, 1.72, and 5.04, respectively) showed significant associations with the onset of diabetes in Ono town, only BMI and late-night dinner (HR = 1.21 and 4.86, respectively) showed significant associations with diabetes onset in Kawauchi village.@*CONCLUSIONS@#The current results confirmed that diabetes incidence was increased 6 years after the Daiichi nuclear power plant disaster in Kawauchi. We also found changes in lifestyle habits, suggesting that diabetes prevention with promotion of healthy lifestyle behaviors is an urgent priority.
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Aged , Female , Humans , Male , Middle Aged , Cohort Studies , Diabetes Mellitus , Epidemiology , Fukushima Nuclear Accident , Health Surveys , Incidence , Japan , Epidemiology , Life Style , Retrospective StudiesABSTRACT
Objective: Although it is well known that smoking is a risk factor for subarachnoid hemorrhage, the association between smoking and unruptured intracranial aneurysms remains unclear. The aim of the present study was to investigate whether smoking status was associated with unruptured intracranial aneurysms among Japanese brain health check-up examinees.Materials and Methods: We conducted a cross-sectional study of 1,496 adults (aged 26–90 years) undergoing brain health check-ups at a single community medical support hospital in Akita, Japan between 2009 and 2013. In Japan, people can discretionarily undergo a brain health check-up for early detection of unruptured intracranial aneurysms or subarachnoid hemorrhages. Participants responded to a questionnaire on lifestyle, such as smoking status, and were classified into three groups: never, former, and current smoker. The evaluation of unruptured intracranial aneurysms detected by magnetic resonance angiography was performed by an expert physician. Multiple logistic regression models were used to estimate the odds ratio for unruptured intracranial aneurysms. We performed statistical analyses by age, sex, and family history of stroke.Results: The number of participants with unruptured intracranial aneurysms was 43 (2.9%). The mean age (standard deviation) and proportion of males was 55.8 (9.5) years and 53.3%, respectively. The adjusted odds ratios (95% confidence intervals) for unruptured intracranial aneurysms of 1.21 (0.48–3.08) among former smokers and 2.88 (1.10–7.50) among current smokers were compared to those of never smokers (p-trend = 0.041). After stratifying by age, sex, and family history of stroke, no interactions were found.Conclusion: This cross-sectional study conducted in Japan showed that smoking was positively associated with unruptured intracranial aneurysms among brain health check-up examinees.
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This standard stipulates the principles, institutional requirements, inspection items, service modes, data management and utilization requirements for carrying out the health check-up for rural residents. It is applicable to the standardized management of the health check-up for rural residents aged 15 years old and above under the relevant national laws and regulations.
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With the acceleration of the population aging in China, the health problems and the demands of health services such as health check-up for rural residents should attract the attention of the whole society. The group standard entitled Health check-up guide for rural residents (T/CHAA 005-2019), was written by experienced researchers from Chinese Center for Disease Control and Prevention and other professional institutes coordinated by Chinese Health Association. The standard aims to establish a service model that takes health information collection as a means, health risk assessment, health risk intervention and information services as the core, improving the health of rural residents as the target.
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Objective To analyze the effect of health check-up feedback style (HCFS) on the blood glucose level and weight of type 2 diabetes patients aged 75 years and older.Methods 120 consecutive patients with type 2 diabetes and aged 75 and older who were taking annual health check-up and receiving paper-based medical examination reports at Peking Union Medical College Hospital were enrolled into this study.The patients were randomly divided into two groups (control group and study group).All patients received annual health check-up between November 2014 and October 2015 (baseline health check-up).Patients in control group were given paperbased feedback as usual,while those in study group received feedback via face-to-face or telephone conversations.All patients received their second annual health check-up between November 2015 and October 2016.The patients' blood glucose and weight at the second health check-up were compared between the two groups.Results In baseline health check-up,the levels of HbA1c and BMI showed no difference between the two groups.In the second health check-up,HbA1c and BMI of study group were lower than control group [(7.17±0.58)％ vs.(7.44±0.72)％,P=0.027;(24.3±3.8) kg/m2 vs.(25.0±4.2) kg/m2,P=0.049].Fast blood glucose and waist circumference showed no difference between the two groups.Conclusions Combination of paper-based reports and face-to-face or telephone conversations to feedback on health check-up results led to better blood glucose and BMI control in old aged type 2 diabetes patients.HCFS is of vital importance.
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Introducción: el examen periódico de salud constituye una herramienta que emplea el médico de familia para iniciar el proceso de evaluación en adultos mayores. Objetivo: describir los resultados del examen periódico de salud. Métodos: se realizó un estudio descriptivo, transversal y retrospectivo en el Policlínico Universitario Pedro Borrás Astorga de Pinar del Río, durante el año 2015, a través de variables seleccionadas. La muestra de estudio estuvo constituida por 7 337 adultos mayores pertenecientes a dicha área de salud y los resultados se expresaron en tablas y gráficos para su mejor comprensión. Resultados: predominó el sexo femenino con 54,6 por ciento, así como el grupo de edad de 65 y más años con 68,6 por ciento. Prevaleció el grupo dispensarial III con 82,6 por ciento fundamentalmente en féminas. El número de exámenes periódicos de salud fueron superiores en el 2015 con 3 806 respecto a años anteriores, donde las afectaciones según escala geriátrica se evidenciaron en el uso de fármacos con 52,2 por ciento. El estado global funcional fue superior al frágil en un 72,6 por ciento. Conclusiones: se caracterizaron los resultados del Examen Periódico de Salud en el Policlínico universitario Pedro Borrás Astorga. El estudio enriquece y amplía el trabajo asistencial, docente, investigativo y gerencial en adultos mayores de dicha área de salud(AU)
Introduction: The periodic health check-up is a tool used by the family doctor to start the evaluation process in aged adults. Objective: To describe the results of the periodic health check-up. Methods: A descriptive, cross-sectional and retrospective study was carried out in Pedro Borrás Astorga University Polyclinic of Pinar del Río, during the year 2015, through selected variables. The study's sample consisted of 7 337 aged adults belonging to the mentioned health area and the results were expressed in tables and graphs for better understanding.Results: The female sex prevailed, with 54.6 percent, as well as the age group of 65 and over, with 68.6 percent. The dispensary group III prevailed, with 82.6 percent, mainly among females. The number of periodic health check-ups was higher in 2015, with 3 806, compared to previous years, in which the effects, according to the geriatric scale, were evidenced in the use of drugs, with 52.2 percent. The global functional state was higher than the fragile one in 72.6 percent. Conclusions: We characterized the results of the periodic health check-up in Pedro Borrás Astorga University Polyclinic. The study enriches and broadens the care, teaching, research and management work in aged adults in this health area(AU)
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Humans , Male , Female , Aged , Aged, 80 and over , Aging , Primary Health Care , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective StudiesABSTRACT
Recently, medical real world data involving claims data, drug data, and electrical medical record database have been developed worldwide and can be utilized for the phrmacoepidemiology research.The results of the pharmacoepidemiology research with these database contribute not only to post-marketing safety research but also to the outcomes research and pharmacoeconomic evaluation. On the other hand, collaborating with a number of local governments, we have developed maternal and child health check-up and school health check-up database in Japan. The development of healthcare lifecourse data like this will contribute to the preventive medicine, the understanding of the rare diseases, and drug development.
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<p>Recently, medical real world data involving claims data, drug data, and electrical medical record database have been developed worldwide and can be utilized for the phrmacoepidemiology research.The results of the pharmacoepidemiology research with these database contribute not only to post-marketing safety research but also to the outcomes research and pharmacoeconomic evaluation. On the other hand, collaborating with a number of local governments, we have developed maternal and child health check-up and school health check-up database in Japan. The development of healthcare lifecourse data like this will contribute to the preventive medicine, the understanding of the rare diseases, and drug development.</p><p></p>
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Objective To investigate the detection rate of abnormal cardiovascular and metabolic indicators in health check-up populations,and provide evidence for early screening and health interventions for cardiovascular and metabolic diseases.Methods A total of 5578 adults (male 3404 and female 2174) were recruited from a medical institution in Beijing in 2008 and 2010.Cardiovascular and metabolic indicators,including blood pressure,lipid profile and fasting plasma glucose,were tested at baseline and 2 years.Paired t test or paired rank sum test was used for data analysis.Results Detection rate of abnormal blood pressure in 2010 was lower than that in 2008; however,rates of abnormal total cholesterol,low-density lipoprotein cholesterol and fasting plasma glucose were higher in 2010 than in 2008 (t values were 5.378,13.885,3.210,10.401 and 4.355,respectively; all P ＜ 0.05).High-density lipoprotein cholesterol and triglyceride showed no statistically significant difference between 2008 and 2010 (t values were 1.204 and -0.012,respectively; both P ＞ 0.05).Conclusion We have been observing a dynamic change in abnormal cardiovascular and metabolic indicators,based on which effective interventions could be taken to reduce the risk of cardiovascular diseases.
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PURPOSE: To compare the detection rate of the patients with retinal nerve fiber layer (RNFL) defect and the amount of RNFL defect according to the patients' age. METHODS: Retrospective chart reviews of 22,811 subjects, who visited the health care center from January 2009 to December 2009 were performed. The detection rate, location and average amount of RNFL defect and the proportions of the patients who were diagnosed with glaucoma through Humphrey visual field (HVF) test or determined as a glaucomatous optic disc were compared according to the patients' age. RESULTS: The proportions of the patients whose RNFL defect were detected was highest in the patients 60 years old or older (2.3%) and was statistically significant (p = 0.012). However, there was no significant difference among the other age groups (under 40 years: 1.7%, 40 thru 49 years: 1.5%, 50 thru 59 years: 2.0%). The proportions of the patients who were determined as glaucoma through the HVF test or glaucomatous optic disc were also highest in the patients 60 years old or older (1.4%), however, there was no statistically significant difference (p = 0.070) among the age groups (under 40 years: 1.1%, 40 thru 49 years: 0.9%, 50 thru 59 years: 1.2%). CONCLUSIONS: The RNFL defect is likely to be detected in subjects less than 40 years of age and the detection rate is similar to subjects in their 40's and 50's. The use of fundus photography to detect RNFL defect in a health care center is recommended in subjects under 40 years of age.
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Humans , Delivery of Health Care , Glaucoma , Nerve Fibers , Photography , Retinaldehyde , Retrospective Studies , Visual FieldsABSTRACT
BackgroundIdiopathic epiretinal membranes(ERMs) is a common eye disease condition that leads to progressive decline of visual acuity. Studying the risk factors relating to this disease will shed light on its pathogenesis and allow opthalmologists to screen the affected individuals among the high-risk population and prepare for prevention and management strategies. ObjectiveThis survey was to investigate the risk factors of idiopathic ERMs in the population undergoing routine health check-ups. MethodsThe clinical data of idiopathic ERMs was obtained from the population of routine health check-ups in Peking Union Medical College Hospital from November 2009 to October 2010. The examination outcomes were compared between the individuals with and without idiopathic ERMs. The demographic and clinical factors associated with idiopathic ERMs were analyzed and assessed using univariate and multivariate logistic regression analyses. Result A total of 27 400 people were included in the survey and idiopathic ERMs were diagnosed in 76 cases. No obvious eye complaint was obtained from the idiopathic ERMs. The number of people affected with idiopathic ERMs was 12 ( 12/11 659 ) in the below 40 years group, 21 (21/4595) in the 51-60 years group and 32 (32/2544) in the over 60 years group. Hypertension, diabetes, diedyslipidemia, renal function insufficiency ,and cataract were found in 42％ ,5％ ,66％ ,6％ and 8％ of the patients, respectively. The univariate logistic regression analyses revealed that significant correlations were found between age,hypertension,hyperlipidemia and history of cataract( P＜0. 01 ). Multivariate regression models showed that the risk of idiopathic ERMs increased in age of 51-60( OR=2. 5,95％ CI:1. 2-5.4,P=0.02) and over 60 years( OR =7.3,95％ CI:3.4-15.6 ,P＜0.01 ) and patients suffering from hyperlipidemia ( OR--2. 1,95％ CI:1. 3-3.5, P＜0. 01 ). ConclusionsOver the age of 50 years and hyperlipidemia are primary risk factors of idiopathic ERM.
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Objective To identify the outcomes and effect of applying the health check-up nursing quality control system developed as supervised by JCI quality assessment standards.Methods The monitoring system for nursing quality in the health check-up department is established within the framework of the hospital quality improvement committee and in line with characteristics of the department.Quality improvement tools may be called into play for analysis and decision making to revolve critical problems found in health check-up nursing,upgrading nursing quality and customer satisfaction.Results Significant rise of health check-up quality and customer satisfaction for nurses,and the nurses are trained in quality control knowledge and get further involved in quality management of their department.Conclusion Health check-up nursing management system under the JCI standard is conducive to raising the nursing quality,and helps nurses with problem analysis and solution.
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This study was done to analyze nutrition counseling services in health promotion center and to investigate demands of subjects for nutrition services. Data was collected through the survey of 90 subjects. The results were as follows. The results of people receiving nutrition services showed that 58.5% of the counseling group and 46.4% of the noncounseling group answered having experience with nutrition services. And 50% of them received nutrition counseling through individual counseling. Diet therapy with health check-up results also appeared the highest in contents of nutrition counseling. As a source of nutrition information and health knowledge, subjects relied heavily or most on the TV, internet, books, magazines, and newspapers. On the other hand, they relied much less on advice from dietitians, nutritionists, medical doctors and nurses. The experience of receiving nutrition services and thinking about nutrition education related positively. It showed that the counseling group (95.1%) was significantly higher than the non-counseling group (80.5%) in necessity of nutrition assessment. But, necessity of nutrition counseling wasn't significantly different between the two groups. The method of nutrition counseling subjects preferred was individual consultation. The subjects answered to having need of analysis and evaluation of nutrient intake and calorie prescription in nutrition assessment and individual nutritional status results explanation in nutrition counseling. In conclusion all people visiting health promotion centers need nutrition service of some kind.
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Counseling , Diet Therapy , Education , Hand , Health Promotion , Internet , Periodical , Nutrition Assessment , Nutritional Status , Nutritionists , Periodicals as Topic , Prescriptions , ThinkingABSTRACT
PURPOSE: To investigate the usefulness of the non-mydriatic digital fundus camera for detection of normal-tension glaucoma in routine health check-ups. METHODS: Among 1986 persons who received a routine health check-up in the Kangnam Health Care Center of Seoul National University Hospital (SNUH) from October to December 2003, 60 patients were referred to the Glaucoma Clinic of SNUH due to a suspicious optic nerve head or a retinal nerve fiber layer (RNFL) defect detected by a non-mydriatic digital fundus camera. The glaucoma work-up was performed, including Goldmann applanation tonometry, red free RNFL photography, Humphrey visual field (HVF), Stratus OCT and HRT II. RESULTS: Among 60 patients with a suspicious optic nerve head or suspected RNFL defect, 23 patients showed a retinal nerve fiber layer defect on red free RNFL photography. Those 23 patients had already demonstrated possible RNFL defects on photographs taken by a non-mydriatic digital fundus camera at their routine health check-up. In comparison with the normal, high PSD value of HVF (p=0.002), the narrow neuroretinal rim area shown by OCT (p=0.05) and HRT (p=0.02) were significantly different statistically. CONCLUSIONS: The non-mydriatic digital fundus camera can serve as a useful tool to screen normal-tension glaucoma in routine health check-up systems. However, the final diagnosis of glaucoma should be confirmed by red free RNFL photography and standard automated perimetry.
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Humans , Delivery of Health Care , Diagnosis , Glaucoma , Manometry , Nerve Fibers , Optic Disk , Optic Nerve , Photography , Retinaldehyde , Seoul , Visual Field Tests , Visual FieldsABSTRACT
OBJECTIVE: The purpose of this study was to obtain an important basic data about the clinical efficacy of the conventional Papanicolaou cervical cytology as a screening tool by estimating the prevalence rate of cervical cancer and precancerous lesion in the general population roughly according to The Bethesda System (TBS). METHODS: This study was performed in Health Check-up Center and Industrial Medicine clinic at Dankook University Medical Center from January 1, 1999 to December 31, 2001. Nine thousand and five hundred fourteen cases who had underwent conventional Papanicolaou cervical cytologic test were analyzed according to The Bethesda System (TBS). Abnormal cytologic diagnoses ((Atypical Squamous Cells of Undetermined Significance (ASCUS) or worse)) were compared with histologic diagnoses as a reference standard. RESULTS: Followings are the results summarized. 1. Of the 9,514 patients, 8 (0.08%) were diagnosed as unsatisfactory for evaluation. Of the 9,506 cases, there were 3,919 (41.23%) cytolologic diagnoses of Within Normal Limit (WNL), 5,368 (56.47%) of Benign Cellular Change (BCC), 131 (1.38%) of ASCUS, 41 (0.43%) of Low-grade Squamous Intraepithelial Lesion (LSIL), 33 (0.35%) of High-grade Squamous Intraepithelial Lesion (HISL), 7 (0.07%) of Squamous Cell Carcinoma (SCC), 7 (0.07%) of Atypical Glandular Cells of Undetermined Significance (AGUS). There was no cytologic diagnosis of Adenocarcinom (ACC). The ASCUS/SIL ratio was 1.77. 2. The age distribution of patients were as follows: 1 case under 19 years, 719 in the 20's, 2,963 in the 30's, 2,650 in the 40's, 2,020 in the 50's, 1,042 in the 60's, 110 in the 70's, 1 over 80 years. The mean age was 44.50 years. 3. Of 9,506 cases, there were 219 abnormal cytologic diagnoses (ASCUS/AGUS or worse). Of 219 cases, 40 (18.3%) showed high-grade cytologic diagnoses (HSIL, SCC, and ACC) if ASCUS and AGUS were excluded. There was no statistically significant relation between cytologic diagnoses and ages. 4. Of 219 cases with abnormal cytologic diagnoses, 38 patients had histologic diagnoses. Of the 9 ASCUS cases, 5 (55.55%) showed positive histologic LSIL or worse diagnoses. Of the 29 cytologic LSIL or worse cases, 22 (75.9%) showed positive histologic LSIL or worse diagnoses. Of the 21 cytologic HSIL or worse cases, 18 (85.7%) showed positive histologic HSIL or worse diagnoses. Of the 4 cytologic SCC cases, 4 (100%) showed high-grade histologic diagnoses (HSIL or SCC). Of 38 cases with histologic diagnoses, 23 (60.53%) showed high-grade histologic diagnoses ((HSIL, SCC, and Adenocarcinoma in situ (AIS)). There was a statistically significant relation between cytologic diagnoses and high-grade histologic diagnoses in squamous abnormalities. CONCLUSION: This study showed that 97.7% of cytologic diagnoses were negative and 60.5% of abnormal cytologic diagnoses (ASCUS or worse) were correlated with high-grade histologic diagnoses according to the criteria of TBS in general population. Our data also confirmed that conventional Papanicolaou cervical cytology is more accurate when a high-grade squamous intraepithelial lesion threshold is used. This study will play a relevant role in clinical practice of cervical cancer screening of general population.