宜兴市2009～2012年农村妇女宫颈癌和乳腺癌筛查结果分析

目的:了解宜兴市农村妇女宫颈癌、乳腺癌筛查状况,掌握农村妇女"两癌"患病率,为"两癌"的防治和治疗提供依据,降低"两癌"治疗成本,提高患病妇女的生存率。方法:按照《江苏省农村妇女宫颈癌和乳腺癌检查项目管理方案》的要求,统一使用卫生部下发表格逐项检查,对其资料进行统计分析。结果:宜兴市2009～2012年共完成了江苏省卫生厅下达的105 868人次的免费检查任务,4年共发现宫颈癌14例,平均患病率13.22/10万,乳腺癌37例,平均患病率34.95/10万。结论:开展农村妇女宫颈癌、乳腺癌检查项目工作,可以对"两癌"做到早发现、早诊断、早治疗的目的,加强健康教育,提高妇女生活质量,同时锻炼了宫颈癌、乳腺癌筛查队伍。     

24099例农村妇女宫颈癌和乳腺癌筛查结果分析

目的:掌握遂昌县农村妇女宫颈癌和乳腺癌(简称"两癌")的发病率,早期发现、早期治疗,降低"两癌"的治疗成本,提高患病妇女的生存率。方法:对2009年自愿参加"两癌"免费筛查的24 099例农村妇女的资料进行统计分析。结果:24 099例妇女中,宫颈细胞学异常578例,经组织活检确诊为宫颈癌18例,患病率为74.69/10万(18/24 099);宫颈上皮内瘤变(CIN)110例,患病率为456.45/10万(110/24 099);乳腺癌2例,患病率为8.3/10万(2/24 099)。宫颈癌多见于40～64岁妇女,乳腺癌多见于50～55岁妇女。结婚和生育年龄较早是宫颈癌的高危因素;文化程度低、保健意识不强、经济条件差的农村妇女是"两癌"的高发人群,也是重点干预对象。结论:农村妇女"两癌"发病率高,应加大农村防癌普查力度,希望政府能继续执行惠民政策,切实做到早预防、早发现和早治疗。     

甘肃省2012至2014年农村妇女"两癌"筛查结果分析

目的 了解甘肃省农村妇女宫颈癌和乳腺癌的发病情况,提高农村妇女的早诊早治率,降低死亡率,提高患病妇女的生存率.方法 根据甘肃省农村妇女两癌检查项目实施方案,对34~65岁农村妇女"两癌"筛查结果进行分析.结果 全省2012至2014年农村妇女宫颈癌检查1768438人,检查出宫颈癌521例,发病率为29.46/10万;3年宫颈癌发病率分别为33.38/10万、25.90/10万、29.20/10万,其差异无统计学意义(χ2=5.646,P>0.05).检查出宫颈上皮内瘤变(CIN)3172例,发病率为179.36/10万,其中CINⅡ~Ⅲ1035例,发病率为58.50/10万;宫颈炎、细菌性阴道病、滴虫性阴道炎的发病率分别为22.36%、10.62%、9.87%;子宫肌瘤发病率为0.97%;共筛查140188例农村妇女,检查出乳腺癌108例,发病率77.04/10万;3年乳腺癌发病率分别为81.48/10万、63.30/10万、84.98/10万,其差异无统计学意义(χ2=1.621,P>0.05).乳腺纤维瘤、乳腺炎、乳腺导管内乳头状瘤以及其他乳腺良性疾病的发病率分别为1.37%、1.78%、0.10%、7.06%.结论 我省宫颈癌和乳腺癌发病率均高,为保障妇女生殖健康,提高妇女健康水平,有必要在全省全面而广泛地开展两癌筛查工作,并提高筛查质量.     

龙海市农村妇女宫颈癌和乳腺癌筛查结果分析

目的:通过对农村妇女宫颈癌和乳腺癌筛查结果的分析,了解农村妇女生殖健康状况,探讨降低“两癌”的患病率、病死率的有效方法.方法:对龙海市14个乡镇中42 985例35 ～ 59岁农村妇女采用妇科检查、宫颈脱落细胞巴氏检查、阴道镜检查和组织病理学检查进行宫颈癌筛查,同时采用乳腺视诊、触诊及相应的乳腺彩超或乳腺钼靶检查进行乳腺癌筛查.结果:宫颈癌筛查42 985例,阴道镜检查457例,组织病理学检查333例,查出宫颈癌前病变119例,宫颈癌7例;乳腺癌筛查42 985例,乳腺彩超检查678例,乳腺钼靶检查173例,病理确诊乳腺癌6例.结论:农村妇女“两癌”检查是提高农村妇女“两癌”的早诊早治率,降低死亡率的有效方法,值得全面推广,应逐步扩大普查对象,并建立长效机制将该项目长期开展下去,必将大大提高农村妇女的健康水平.     

2018—2020年长沙市开福区农村适龄妇女“两癌”免费检查结果分析

目的 探讨长沙市开福区2018—2020年农村适龄妇女“两癌”免费检查结果,为更好地开展农村女性群体健康服务提供依据。 方法 对2018—2020年开福区11 262例农村适龄妇女免费“两癌”检查结果进行回顾性分析。 结果 检查出宫颈癌3例、乳腺癌6例,患病率分别为26.64/10万、53.28/10万。宫颈癌早诊率达97.65%,乳腺癌早诊率66.67%。另检查出其他恶性肿瘤2例。 结论 政府主导及科学的组织管理是农村妇女“两癌”检查实施的保障。通过对农村适龄妇女进行“两癌”免费检查,可以提早发现“两癌”或者癌前病变,对患者疾病的早期治疗和预防、对降低“两癌”的发病率有着极其重要的意义。     

常熟市农村妇女宫颈癌和乳腺癌筛查服务模式探讨

目的探讨农村妇女开展宫颈癌和乳腺癌筛查服务模式。方法 2010—2011年对常熟市农村35～59周岁妇女开展两癌筛查,以患病率、癌症检出率作为评估效果,与2009年农村妇女病普查相比较。结果 2010—2011年开展宫颈癌筛查妇女53 842人,妇科疾病检出率为23.54%,宫颈癌前病变为1.36‰,宫颈癌为13.0/10万;乳腺癌筛查53 874人,检出率为10.9%,乳腺癌检出率18.56/10万,两癌筛查患病率、癌症检出率明显高于普查。结论两癌筛查患病率、癌症检出率明显高于普查,应将两癌模式取代传统的普查模式,不断提高农村妇女的身心健康。     

山东省章丘市94116例农村妇女“两癌”及妇科疾病调查研究

目的通过2013年对章丘市35～59岁本地农村户籍已婚妇女进行以宫颈癌、乳腺癌为重点的“两癌”筛查工作,了解章丘市35～59岁“两癌”发病率及妇科疾病发生率,以进一步提高“两癌”的早诊早治率,降低死亡率,进行有效的群体防治。方法对94116例农村妇女采取知识问卷、妇科检查、乳腺手诊、宫颈液基细胞学检查（TCT）、阴道镜、宫颈活组织病理、彩超、乳腺钼靶等方法,对宫颈癌、乳腺癌进行筛查。结果筛查发现妇科疾病患者18474例,患病率达210．7％o;各类乳腺疾病12207例,患病率达129．7‰;宫颈癌检出率为0．96／万,乳腺癌的检出率达6．5／万。结论经普查发现近年来章丘市“两癌”患病率仍较高且呈上升趋势,故积极有效的加强对农村妇女的健康教育、强化妇幼保健三级网络建设、提高基层人员业务水平、合理治疗癌前病变、及时诊断治疗“两癌”等干预措施,是促进早诊早治、提高患病人群的生活质量、降低死亡率的关键。     

2009～2011年宜兴市农村妇女宫颈癌和乳腺癌筛查项目结果分析

目的:了解宜兴市35～59岁农村妇女宫颈癌、乳腺癌的发展趋势并探讨有效干预方法。方法:收集2009～2011年参与妇女"两癌"筛查单位上报的各类妇女检查登记表进行分析。结果:项目完成率109.15%,目标人群"两癌"防治知识普及率95.29%,检出宫颈癌前病变432例,其中CINⅠ265例,CINⅡ105例,CINⅢ62例;宫颈癌10例,检出率1.32/万。乳腺癌23例,检出率3.03/万。结论:免费为农村妇女提供宫颈癌和乳腺癌普查普治是提高妇女"两癌"早诊早治的有效举措。     

贵阳市2015-2019年农村妇女宫颈癌和乳腺癌筛查情况分析

目的 了解贵阳市2015-2019年农村妇女宫颈癌和乳腺癌（简称“两癌”）筛查状况,为“两癌”的筛查模式和防治对策提供科学依据。 方法 提取妇幼重大公共卫生项目信息直报系统数据,对贵阳市2015-2019年“两癌”筛查数据进行分析。 结果 2015-2019年贵阳市接受宫颈癌筛查的妇女共计240 074例,分别检出CIN1、CIN2和CIN3、宫颈癌为343例、398例和55例,检出率分别为142.87/10万、165.78/10万和22.91/10万。各年份仅CIN1的检出率差异有统计学意义（x2=25.664, P ＜0.001）;接受乳腺癌筛查的妇女共15 791例,检出乳腺癌9例,检出率为56.99/10万,各年份检出率无统计学差异（x2=2.897, P =0.575）。 结论 贵阳市宫颈癌和乳腺癌检出率水平总体较高,一方面应继续鼓励更多的农村妇女参与“两癌”筛查,知晓筛查的重要性;另一方面要加强对农村妇女的健康宣教,提高对“两癌”防治知识的知晓率,做到“三早”预防以降低“两癌”的发病率和死亡率,保护妇女健康。     

随州市农村妇女两癌筛查项目实施情况分析北大核心CSCD

目的提高我市农村妇女乳腺癌、宫颈癌(以下简称"两癌")的早诊早治率,降低死亡率,提高广大农村妇女健康水平。方法通过在非月经期采集阴道及宫颈分泌物,并结合乳腺手诊、超声、钼靶及病理检查判断是否患"两癌"。结果随州市2013年农村妇女乳腺检查8.6174万人,乳腺疾病患病率为16.16%,其中乳腺增生占94.03%,乳腺纤维瘤等良性疾病占5.82%,查出乳腺癌22例,乳腺癌患病率为25.53/10万;宫颈检查8.3376万人,妇科疾病患病率为58.83%,其中宫颈炎占52.78%,阴道炎占11.9%,子宫肌瘤及其他良性病变占0.87%,查出CIN 90例,检出率为107.94/10万,宫颈癌9例,检出率为10.8/10万。结论广泛开展农村妇女"两癌"筛查项目,及早诊断、治疗妇科疾病和乳腺疾病,是做好"两癌"防治工作的重要手段,也是降低农村妇女死亡率、提高农村妇女健康水平的有效途径。     

Breast cancer, colorectal cancer, and esophageal cancer

This is the second of a six-part series on metastatic spread and natural history of 18 common tumors. Part one summarized symptom/problem anticipation, cancer metastasis, and the 18 tumors that each cause more than 6,000 deaths per year in the United States. Bladder and brain cancer were discussed, with information given on tumor types, metastatic spread and invasion, and common symptoms. Part two charts the natural histories of breast, colorectal, and esophageal cancers. Each of these cancers is presented separately, with information given on mortality rates, the most common tumor types, sites of metastases, common problems, and common oncologic emergencies. Sites of spread, resulting problems (including site-specific symptoms), and assessment parameters are presented as tables. Material is presented so that clinicians will be able to anticipate the spread of these cancers and thus identify problems early in their development so that the problems are more easily managed.     

Attributed risk to smoking for lung cancer,laryngeal cancer and esophageal cancer

OBJECTIVE: Lung, laryngeal and esophageal cancers have smoking as one of their main risk factors. The objective of this study was to evaluate the population attributed risk (PAR) of smoking for these forms of cancer. METHODS: The study was based in three case-control studies conducted in medium size cities in Brazil. Incident cases of lung cancer, laryngeal cancer and esophageal cancer seen at a hospital setting and diagnosed through biopsy were analyzed; controls were hospitalized patients with another diagnoses. Smoking was the exposure factor measured at three levels: non-smokers, former smokers and smokers, which were defined using a questionnaire applied by trained interviewers. For effect measure, odds ratio was used and the populational attributed risk for smoking was then calculated for a 95% CI. RESULTS: A total of 122 lung cancer cases and 244 controls, 50 cases of laryngeal cancer and 48 cases of esophageal cancer, and 96 controls for both of them were studied. The prevalence of smoking exposure was 34%, which is the overall prevalence of smoking in this city's adult population. Odds ratios (OR) for the PAR analysis were the adjusted OR for confounding variables from each study. Lung cancer PAR was 63% (95% IC, 0.58-0.68) for former smokers and 71% (95%IC, 0.65-0.77) for smokers. Larynx cancer PAR was 74% (95% IC, 0.70-0.78) and 86% (95%IC, 0.81-0.85) for former smokers and smokers, respectively. Esophageal cancer PAR was 54% (95%IC, 0.46-0.62) for smokers. CONCLUSION: Smoking is an avoidable risk factor and smoking cessation could be responsible for significant reductions in the incidence of these three forms of cancer.     

Beliefs about causes of cancer in cancer patients

Beliefs about causes of cancer were studied in 120 patients with late-stage cancer and compared with beliefs of non-cancer patients matched for age, sex, and hospitalization. Cancer patients consistently had less strong beliefs about causes of cancer than did the other groups, even when causes such as smoking and having pulmonary cancer were probably associated with the development of their disease. Although some correlates of beliefs were found in cancer patients' personal and social background, these were generally of minimal levels of statistical significance. Those who had been diagnosed longer believed cancer was more often inherited. The non-cancer patients' beliefs were similar to those found in a large survey of the general population. It is likely that cancer patients need to defend themselves against self-blame as a means of coping with a terminal illness.     

Personalized cancer vaccines: Targeting the cancer mutanome

The development of next generation sequencing technologies has revolutionized our understanding of how specific genetic events contribute to cancer initiation and progression. Dramatic improvements in instrument design and efficiency, combined with significant cost reductions has permitted a systematic analysis of the mutational landscape in a variety of cancer types. At the same time, a detailed map of the cancer mutanome in individual cancers offers a unique opportunity to develop personalized cancer vaccine strategies targeting neoantigens. Recent studies in both preclinical models and human cancer patients demonstrate that neoantigens (1) are important targets following checkpoint inhibition therapy, (2) have been identified as the target of adoptive T cell therapies, and (3) can be successfully targeted with personalized vaccines. Taken together, these observations provide strong rationale for the clinical translation of personalized cancer vaccines.     

Nutrigenetics in cancer research--folate metabolism and colorectal cancer

The B vitamin folate is essential for one-carbon transfer reactions, including those related to the methylation of DNA or other substrates and nucleotide synthesis. Epidemiologic and experimental studies implicate low-folate intakes in elevated risk of colorectal neoplasia and suggest that biologic mechanisms underlying this relation include disturbances in DNA methylation patterns or adverse effects on DNA synthesis and repair. With the completion of the Human Genome Project, a vast amount of data on inherited genetic variability has become available. This genetic information can be used in studies of molecular epidemiology to provide information on multiple aspects of folate metabolism. First, studies linking polymorphisms in folate metabolism to an altered risk of cancer provide evidence for a causal link between this pathway and colorectal carcinogenesis. Second, studies on genetic characteristics can help clarify whether certain individuals may benefit from higher or lower intakes of folate or nutrients relevant to folate metabolism. Third, studies on genetic polymorphisms can generate hypotheses regarding possible biologic mechanisms that connect this pathway to carcinogenesis. Last, genetic variability in folate metabolism may predict survival after a cancer diagnosis, possibly via pharmacogenetic effects. To solve the puzzle of the folate-cancer relation, a transdisciplinary approach is needed that integrates knowledge from epidemiology, clinical studies, experimental nutrition, and mathematical modeling. This review illustrates knowledge that can be gained from molecular epidemiology in the context of nutrigenetics, and the questions that this approach can answer or raise.