Analysis of cervical cancer screening results in women aged 50 and older in Beijing and Guizhou / 中华肿瘤杂志

ABSTRACT

Objective@#To analyze the screening results of cervical cancer in elderly women in Beijing and Guizhou. To compare the screening effectiveness of cervical cancer in elderly women in different areas.@*Methods@#A retrospective analysis was performed on the screening data of elderly women (≥50 years) who had examination at cervical lesion clinic in Peking University People′s Hospital and Affiliated Hospital of Guizhou Medical University from January 2013 to January 2014, with histopathology as the gold standard, to compare screening effectiveness of cervical cytology or HPV detection for elderly women in cervical cancer screening in the two regions.@*Results@#Among the patients with cervical intraepithelial neoplasia grade 2 and above (CIN2 + ) detected by colposcopy in Peking University People′s Hospital and Affiliated Hospital of Guizhou Medical University, 44.1% (82/186) and 57.0% (98/172) were women aged 50 and older. In Beijing group 39.0% (32/82) of CIN2 + patients had clinical symptoms, which in Guizhou group was 31.6% (31/98). In Beijing group and Guizhou group, 50.0% (19/38) and 73.2% (30/41) patients with cervical cancer had never been screened, respectively. In Beijing group and Guizhou group, 5.4% (4/74) and 19.2% (10/52) of the patients with CIN2 + had cervical cytology negative for intraepithelial lesion or malignancy (NILM), respectively (P=0.015). The cervical cytology showed atypical squamous cells of undetermined significance (ASC-US) in 10.2% (13/127) and 24.6% (14/57), respectively, with significant difference (P=0.01). The cervical cytology showed low-grade squamous intraepithelial lesions (LSIL) in 14.9% (11/74) and 37.5% (6/16) with no significant difference (P=0.08). Atypical squamous cells cannot exclude high-grade squamous intraepithelial lesions (ASC-H) were 41.7% (5/12) and 71.4% (20/28) with no statistically significant difference (P=0.15). High-grade squamous intraepithelial lesions (HSIL) were 78.9% (15/19) and 86.4% (19/22) with no significant difference (P=0.83). In cases with HPV detection information, the sensitivity of CIN2+ diagnosis by high-risk HPV detection in Beijing group and Guizhou group was 95.2% (40/42) and 73.6% (39/53) that was statistically significant (P<0.05).@*Conclusions@#In both Beijing and Guizhou, the incidence of CIN2+ in elderly women is at a relatively high level. There were differences in the detection of CIN2+ by cervical cytology or HPV detection in Beijing and Guizhou.