[子宫癌。分析流行病学]。

Revista de sanidad e higiene publica Pub Date : 1993-05-01
A Gimeno Ortiz, R Jiménez Romano, J R Camps Pérez del Bosque
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引用次数: 0

摘要

背景:宫颈恶性肿瘤是年轻女性死亡的重要原因。通过发现和早期诊断的社区方案,大大减少了入侵形式的发病率和由于这一原因造成的死亡率。了解性活跃女性人群中癌前病变和癌症的患病率,确定不同因素的风险频率以及这些因素在该人群中的相关风险,是本研究目标的一部分。方法:采用横向研究方法,从15个地区计划生育中心7222名护理人员中随机抽取年龄在20岁及以下、性生活活跃的妇女4262人。在每个病例中,阴道镜检查都是以系统的方式进行的,并与每个非典型图像的细胞学活检相关联。在研究的危险因素中,包括接触Rx、性乱交、生殖器感染、真菌病和不孕症。存在,作为临床发现,怀疑病变或不典型阴道镜检查包括作为危险标志。分析采用检验、比值比计算、95%置信区间、病因分值、多变量分析和OR计算,对定性变量进行调整,对定量变量进行均数比较。软件采用SAS程序。结果:乳腺癌检出率为0.938 / 1000,先兆病变发生率为38.2 / 1000。关于良性恶化或正常的妇女与诊断为癌前病变或癌的妇女之间的不同变量的比较研究证明,在年龄、开始性关系和怀孕次数方面没有差异,但患宫颈癌的风险随着性乱交、服用Rx、生殖器感染、真菌病和不孕症而增加。结论:根据检测到的患病率,认为有必要保持和增加妇女预防宫颈癌行动的覆盖率,增加性活跃妇女对方案的整体参与。危险因素的存在会改变妇科对照的次数和周期。
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[Cervical cancer of the uterus. Analytic epidemiology].

Background: Malignant tumour in cervix is an important cause of death in young women. Through community programmes of detection and early diagnosis, a significant reduction in the incidence of invading forms and mortality due to this cause has been achieved. Knowing the Prevalence of premalignant lesions and cancer in the sexually active women population, establishing the frequency of risk to different factors and associated risk to these ones in this population, constitutes a part of this study objectives.

Methods: A transversal study is carried out, with a sample of population older than 20 years or younger, but sexually active, constituted by 4262 women, selected at random from a population of 7222 persons cared in family planning centers and distributed in 15 localities. In every case, the colposcopy has been made in a systematic way, associated to the cytology with a biopsy of every atypical image. Among the risk factors studied, the expositions to Rx, sexual promiscuity, genital infections, mycosis and infertility are included. The existence, as a clinical discovery, of a suspected lesion or an atypical colposcopy are includes as risk markers. The test of, the calculation of Odds Ratio, and 95% confidence interval, the etiological fractions, the multivariant analysis and the calculation of OR, adjusted to qualitative variables and the comparison of means for quantitative variables, are used in the analysis. The programme SAS is used as a software.

Results: The prevalence of cancer found was 0.938 per one thousand women and the frequency of precursory lesions was 38.2 per one thousand. The comparative study with regard to different variables between women with benign deteriorations or normality and women presenting a diagnosis of premalignant lesions or carcinoma, proves that, without existing differences in relation to age, beginning of sexual relations ans number of pregnancies, the risk of suffering from cervix cancer increases with sexual promiscuity, exposition to Rx, genital infections, mycosis and infertility.

Conclusions: On the basis of the prevalence detected, it is considered necessary keep and to increase the coverage of actions of cervix cancer prevention in women, increasing the participation of the whole of sexually active women in the programmes. The presence of risk factor would modify the number and periodicity of gynecological controls.

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