| Obejective:Xinjiang is one of the cervical cancer high prevelance areas,Uyghurwomen’s incidence is highest in all minorities in China. Lack of screening program andknowledge for cervical cancer, rate of early detection and early diagnosis is very low.Inthis study, through careHPV test and Thinprep detection of6000women in HotanKarakax county, try to search a proper screening method. Meanwhile, by questionnairesurvey that include risk factors of cervical cancer and women’s knowledge for cancer andHPV virus, to discuss the related factors of Uyghur women, and to obtain women’sknowledge of cervical cancer, providing the therotical basis for future intervention project.This is first time in Xinjiang to survey women’s attitude for HPV vaccination, aim toguide vaccination work in the future.Method:1. careHPV test and Thinprep test was conducted in this study, women withpositive result of any of the test would accept colposcopy and cervical biopsy. Diagnosticevaluation has done to three detection method, sensitivity, specificity, predictive positivevalue and predictive negative value have been calculated and also the AUC, by drawingROC curve, diagnostic value has been compared. SPSS19.0software used for statisticalanalysis.2. We performed face-to-face closed survey to every woman, the questionaireinclude women’s education level, occupation, economic status, marriage status, sexual life,sexual hygene and passive smoke. Qualitative data was used for frequency discription,Quantitative data used mean±standard deviation, difference of HPV infection rateapplied2test. High risk of HPV infection used logistic regression method.3.This part ofquestionaire survey include women’s knowledge of cervical cancer and HPV virus,contents include high risk of cervical cancer, common symptoms, screening method, alsoinclude women’s acceptance of HPV vaccine and their affordable ability. Level of difference of knowledge applied Χ2test.High risk factors of low awareness used logisticregression model.Results:1.CareHPV test showed high sensitivity of96.4%and negative predictive valueof96.2%, but specificity and positive predictive value were low. Domestic Thinprep testhas good diagnostic value, sensitivity and specificity were relatively63.2%and75.9%，92.0%for positive predictive value and32.1%for negative predictive value, area underthe ROC curve was0.695. The AUC was0.522for parallel test of two method and was0.759for series test. When we did split-flow test of careHPV and TCT, it showed a bettervalue for the test of TCT split-flow for HPV positive result.2.505women were detectedas HPV positive in6000cases, infection rate was8.42%. Infection rate was increased bythe older of age, positive rate is higher for women older than45than women younger than45. Women who was married again, non pesants, high education level, high income andwith cancer family history had higher HPV infection rate. Women who delivered at home,using sanitary towel during menstruation period, using soil in toilet, cleaning the vaginalbefore and after sexual intercourse, husband smoking showed more likely to infected byHPV. Women who was older than30, HPV positive, using oral contraceptives, using soilin toilet and had never done gynocological examination has higher risk for CIN2+lesions.3. Women of2.18%have best knowledge of cervical cancer, and85.12%have noperception or wrong understanding for cervical cancer. In6000women, there were only13women heard of HPV before, and93.9%women willing to accept HPV vaccine,96.5%willing to let their daughter accept HPV vaccine. But women of91.2%able to afford thevaccine price lower than100RMB. After analysis of risk factors, the study has concludethe factors include age older than45, peasants, low education level and lower familyincome, delivery times more than3, more times of marriage, using soil in toilet, etc. wererelated to low awareness.Conclusion:1.This is the first time of applying careHPV test in Uyghur women’s cervicalcancer screening in Xinjiang. CareHPV method has been tested through clinical trial.CareHPV has high sensitivity, and in series test, split-flow by TCT after screening bycareHPV also showed high diagnostic value.careHPV has a bright future in screeningproject in Xinjiang rural areas since it is a simple, convinient and low-price method.Domestic Thinprep test and colposcopy method also showed good screening value, but theprice of Thinprep test is relatively high, and hospitals of rural areas lack of pathologicaldoctors, colposcopy were not prevelance in many rural areas, therefore, whether TCT andcolposcopy can be applied in cervical cancer screening in Xinjiang rural regions needs further investigation to prove.2. Incidence of CIN2+of Uyghur women older than30washigher than30years under, so we can conclude that the started age suggested in manyscreening guideline also proper for Uyghur women. In this study, high education level andhigh economic level is the risk factors of HPV infection.This result maybe because ofwomen with higher education and economic level had more free sex perception and hadmore free sex life. Through the analysis of risk factors of HPV infection, we can concludethat Uyghur women’s HPV infection is related to poor personal hygene habit, poor sexuallife habit and passive smoke. Therefore, we need to educate women to develop goodhygene and sex habit, and courage them to adapt condom for contraception.3. Women’sknowledge was poor in this study, so it needs enhancement of education work. Theknowledge of women mostly from the doctors and through televion programs, it guide usneed to improve doctors knowledge at local hospitals, and made more attractive TVprogram to disseminate cancer related knowledge. Uyghur women showed well attitudetowards HPV vaccine, but the affording ability is poor. Therefore, government needs toput up some policy to share the fee of vaccine. The risk factors of bad awareness is similarto HPV infection and CIN2+, so by educating women of cervical cancer relatedinformation, we can lead women to develop a healthy life habit, and decrease theincidence of Uyghur women’s cervical cancer. |
PDF Full Text Request