子宫颈癌筛查热点.pdf

子宫颈癌筛的热点 HPV是否可用做为一线筛查 Chengquan Zhao, MD Professor of Pathology University of Pittsburgh Medical Center zhaoc@upmc.edu 2015 中国细胞病理年会, 合肥, 2015-6-12 DISCLOSURES AND BACKGROUND The presenter has no relevant financial relationship with any commercial interest to disclose other than employment in the Gynecologic Pathology Division of UPMC. Professional Training and Background: Gyn/Breast Surgical Pathology Fellow: AFIP 2004.7-2005 .6 Cytopathology Fellow: University of Southern California 2005.7-2006.6 Microbiology-Virology: Qingdao Medical College 1988-1992 Gyn/Breast pathologist-Cytopathologist: Magee-Women Hospital, UPMC 2006.7 to present 大纲  子宫颈癌发病率  美国宫颈癌筛查历史及新的宫颈癌筛查指 南要点  美国新的宫颈癌筛查试验异常及癌前病变 的处理共识指南要点 HPV做为一线筛查的利弊  HPV检测阴性的子宫颈癌 宫颈癌: 2008年全球癌症统计数据  世界范围内：女性第三大最常见癌症  世界范围内：530,000/年  85% 发生在发展国家或地区  印度：134,420/年, 占全世界25% 的病例  中国：75,434/年, 占全世界14%的病例  美国：11,069/年, 占全世界2.1% 的病例  英国：2729/年，仅占0.5% WHO宫颈癌在中国 2008年全球癌症统计数据  发病数: 75434/年, 占所有癌症的6.3%  发病率：9.6/10万  死亡数33914/y  死亡率：4.3/10万 这些数据都正确吗？？ Prevalence of HR-HPV by Residence, China Int J Cancer 2012;131:2929 Int J Cancer 2012;131:2929  Findings indirectly raise the possibility that cervical cancer incidence in China may be higher than currently estimated: 9.6/10万.  Chinese cancer registries on which nationwide cancer incidence is estimated include only 2% population and are located in five urban settings 中国癌症基金会宫颈癌防治协作组 第十次会议(2012.4.26)  估计：我国宫颈癌的发病率约为30/10万， 并有明显的地区差异★  新疆 伽师 策勒 筛查人数 2822 7971 宫颈癌检出率 459