关于喀麦隆北部患宫颈癌妇女的社会和教育状况以及对其疾病的了解状况的调查

A. H. N. Kamdje, G. Kalgong, R. S. Tagne, J. M. Amvene, C. Nangue
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摘要

摘要:背景:宫颈癌是世界范围内女性死亡的主要原因。这种病理的死亡率和发病率的降低取决于基于强大的筛查方法的早期发现,这将导致最佳的治疗策略。然而,在发展中国家的一些农村地区,很难获得标准的筛查方法,因此更便宜和易于操作的替代筛查方法是有用的。目的:比较醋酸目视检查(VIA)和碘目视检查(VILI)与子宫颈抹片检查(Pap Smear)对宫颈癌筛查的敏感性和特异性,评价在北喀麦隆地区卫生院采用VIA-VILI关联法开展基于早期诊断的宫颈癌流行病学监测的可行性。本研究共招募年龄在20 ~ 62岁的女性309例,其中307例纳入统计分析。每个妇女都通过常规涂片和5%醋酸和lugol溶液的目视检查来筛查宫颈癌。结果:在我们的研究中,我们发现宫颈癌前病变的患病率为12.70%。宫颈癌的危险因素包括年龄、婚姻状况、第一次性行为年龄和胎次。VIA与VILI相关性的敏感性、特异性、阳性预测值和阴性预测值分别为93.58%;97.01%;82.01%、99.04%。结论:与巴氏涂片相比,VIA或VILI可作为发展中国家宫颈癌的替代筛查方法。然而,组织学检查被推荐使用“金标准”来评估VIA/VILI的检测准确性,因为它可以用于诊断癌症,而PAP涂片不能。
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An Inquiry on the Social and Education Status of Women from Northern Cameroon Suffering Cervical Cancer and the State of Knowledge of their Disease
Abstract: Background : Cervical cancer is a major cause of women death worldwide. The reduction of the mortality and morbidity of this pathology depends on the early detection based on powerful suitable screening methods, that will lead to optimal treatment strategies. However in some rural region of developing countries, it is very difficult to get access to standard screening methods, alternative screening methods, cheaper and easy to handle are then useful. Objective : The aim of this work was to test the sensitivity and specificity of VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol iodine) as screening test of cervical cancer compared to the Pap Smear, evaluating the feasibility in health formation in the North Cameroon region, of implementing epidemiological surveillance of cervical cancer based on early diagnosis using the VIA-VILI association Method : 309 women age 20 to 62 years were recruited in this study, 307 were included in the statistical analyzes. Each woman was screened for cervical cancer by a conventional Smear and visual inspection with acetic acid 5% and the lugol solution. Results : We found in our study a prevalence of precancerous lesions of cervix at 12.70%. The risks factors of cervical cancer identified are age, matrimonial status, age of first sexual intercourse and parity. The association of VIA and VILI showed a sensitivity, specificity, positive and negative predictive value respectively about 93.58%; 97.01%; 82.01%, 99.04%. Conclusion : Compared to PAP Smear, VIA or VILI could be used as an alternative screening methods for cervical cancer in developing countries. However, histology test was recommended to use a « Gold Standard » to evaluate the test accuracy of VIA/VILI because it can be used to diagnose cancer, while PAP smear cannot.
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