Study Of Cervical Cancer Screening Methods And Strategies From Bachu County In Xinjiang

Objective: Through the screening of Xinjiang Uighur women cervical cancer in BachuCounty, to understand the current status of early diagnosis of cervical cancer screeningarea and the basic information of a woman’s uterus,to valuate multiple screening methodssystematically and specifically and explore various screening strategies suitable forregions such as Xinjiang rural economic backward areas;to evaluate the diagnostic valueof Cervista for the prediction of Uighur women cervical lesions.Methods： According to Bachu county geographical location, populationdistribution,economic status, randomly selected four townships plus a town of marriedwomen20-65years5,045people for the survey, the use of interviews conducted aquestionnaire survey of women’s basic information, gynecological examination,TCTdetection, care HPV detection and VIA/VILI detection.The performance of them,such asSe,Sp,et al.were analyzed..Specific research on TCT, VIA/VILI,and HPV DNA test wereperformed based on data from several projects and rural demonstration site for earlydiagnosis.The clinical accuracy of Cervista HR HPV DNA was tested in across-sectionalpopulation based study.Considering various health-resource settings,several screeningalgorithms were developed by combining screening tests and their accuracy wereevaluated by pathology.Results:1.5045people completed questionnaires and participate in cervical cancerscreening, completion rate of100.9%.The education level screening is generally low.Theinvestigation object of minimum age of20years, the maximum age of65years old, theaverage age was39.47士9.73years old.Through screening, detect CINII and above casesfor67cases,1.33%detection rate, early detection rate of85.1%.HPV positive detectionrate is9.93%.Women over the age of35CIN Ⅱ magnitude disease incidence rateincreased significantly.HPV infection rate increased gradually from the positive rate after age40-45.2. Screening method of general features:Se and Sp for VIA/VILI were53.2%and68.7%respectively;Se and Sp for TCT were65.6%and85.0%;Se and Sp for HPVwere85.1%and42.8%;Se and Sp for colposcopy were94.2%and77.5%.3. AUC forHPV primary testing followed by TCT triage was the larggest(0.794）;Se, Sp for solelyVIA/VILI screening, VIA/VILI primary testing followed by HPV triage, VIA/VILIprimary testing followed by TCT triage were53.2%,68.7%and40.9%,68.7%and35.1%,99.06%.4.373cases of Uigur women do Cervista detection In5045cases ofscreening.HR-HPV infection rate with the cytological diagnosis, pathological grade levelincreases, the difference was statistically significant (P <0.05).The positive rate of A9group was highest in pathology and cytology positive group, the difference was significant(P <0.05).Conclusion:1.Detection of≥CIN II grade disease rate was1.33%, the infection rate ofHPV (9.93%) in Xinjiang Uygur women in Bachu County, less than Chinese othercervical cancer high incidence area.Suggestions for the screening of cervical lesionsshould be in more than30years old of sexual life of women, the focus is on women overage35.2. Colposcopy examination in the diagnosis of value better than the rest of the threemethods, can be used as the method of choice for cervical cancer screening, but needprofessional and technical personnel, difficulties in rural grassroots promotion;TCT testingis difficult to promote in rural grassroots,too;care HPV and VIA/VILI test is suitable forthe less developed areas of rural primary cervical cancer screening.3. HPV primary testingfollowed by TCT triage is the most valuable method for cervical cancer screening.HPVprimary testing followed by TCT triage will be more appropriate for theareas lack ofmedical resources such as Xinjiang rural economic backward areas.4. The date fromCervista and care HPV tests was consistent. It could be used as a reliable screening tool ina clinical test. Cervista HPV testing can be used as a kind of care HPV and TCT sensitiveshunt method used in large-scale cervical cancer screening check.The A9group had highprognostic value of CIN and cervical cancer in Uighur women.