祥云县农村女性宫颈癌认知及自取样HPV准确性分析OA
Analysis of Cervical Cancer Awareness and Self-sampling HPV Testing Accuracy Among Rural Women in Xiangyun County
目的 分析云南省祥云县农村妇女对宫颈癌的认知情况、高危型人乳头瘤病毒(human papillomavirus,HPV)感染状况及自取样HPV检测准确性.方法 2023 年 12 月至 2024 年 12 月招募祥云县三个乡镇农村常住 21～65 岁有性生活史的女性进行健康宣教,并于宣教前后进行宫颈癌认知的问卷调查.随后,指导入组对象自行采集阴道分泌物标本一份,并由妇科医生采集宫颈脱落细胞标本一份.所有样本采用基于聚合酶链反应(polymerase chain reaction,PCR)的HPV检测方法进行 15 种高危型HPV检测,对于HPV检测阳性的妇女,建议其接受阴道镜检查或进一步治疗.观测指标包括调查对象对宫颈癌及其防治相关知识的知晓率,高危型HPV阳性率及检测一致率.结果 本研究入组 615 例女性,其中,汉族占 85.0%,少数民族占 15%,接受小学教育及未接受教育 357 例(58.0%),接受初中及以上教育有 258 例(42.0%).健康宣教后,妇女对宫颈癌(100.0%vs 88.0%)、HPV(100.0%vs 64.6%)、HPV与宫颈癌相关(58.9%vs 10.1%)、宫颈癌的预防(98.0%vs 56.1%)、HPV疫苗(99.0%vs 31.1%)、农村宫颈癌免费筛查项目(98.9%vs 31.7%)的知晓率均得到明显提升(P<0.05).自取样HPV阳性率为 9.9%,其中HPV-16/18 阳性率为 1.6%,医生取样HPV阳性率为 8.6%,其中HPV-16/18 阳性率为 1.8%.自取样与医生取样检测结果Kappa值为 0.517,表明一致性尚可,但仅 40%的筛查妇女优选自取样方式.结论 云南祥云县农村妇女对宫颈癌及其预防的认知水平偏低,健康教育能有效提升认知水平,需重视向筛查对象提供易于理解的健康教育.自取样与医生取样HPV检测结果一致性较好,有望作为农村医疗资源不足地区宫颈癌筛查的补充手段.
Objective To analyze the awareness of cervical cancer,high-risk human papillomavirus(HPV)infection status,and accuracy of self-sampling HPV detection among rural women in Xiangyun County,Yunnan Province.Methods From December 2023 to December 2024,rural women aged 21～65 years with sexual history from three townships in Xiangyun County were recruited for health education.Questionnaire surveys on cervical cancer awareness were conducted before and after the health education intervention.Subsequently,enrolled participants were instructed to self-collect vaginal secretion specimens,while gynecologists collected cervical exfoliated cell specimens.All samples were tested for 15 types of high-risk HPV using polymerase chain reaction(PCR)-based HPV detection methods.Women with positive HPV results were recommended to undergo colposcopy or further treatment.Observed indicators included awareness rates regarding cervical cancer and related prevention knowledge,high-risk HPV positivity rate,and detection concordance rate.Results A total of 615 women were enrolled,of whom 85.0%were Han Chinese and 15.0%were ethnic minorities.Among these,357 women(58.0%)had received primary school education or no formal education,while 258 women(42.0%)had received junior high school education or above.Following health education,the awareness rates among women regarding cervical cancer(100.0%vs 88.0%),HPV(100.0%vs 64.6%),the correlation between HPV and cervical cancer(58.9%vs 10.1%),cervical cancer prevention(98.0%vs 56.1%),HPV vaccination(99.0%vs 31.1%),and the free rural cervical cancer screening program(98.9%vs 31.7%)all showed significant improvements(P<0.05).The HPV positivity rate for self-sampling was 9.9%,with HPV-16/18 positivity rate of 1.6%,while the HPV positivity rate for physician-sampling was 8.6%,with HPV-16/18 positivity rate of 1.8%.The Kappa value for concordance between self-sampling and physician-sampling results was 0.517,indicating fair consistency;however,only 40%of screened women preferred the self-sampling method.Conclusion The awareness level of cervical cancer and its prevention among rural women in Xiangyun County,Yunnan Province is relatively low.Health education can effectively improve awareness levels,necessitating provision of easily understandable health education to screening participants.Self-sampling and physician-sampling HPV detection results demonstrate good concordance and may serve as a complementary approach for cervical cancer screening in areas with limited rural medical resources.
徐鑫樾;段如菲;罗克惠;杨宏英;杨红艳;杨社叶
祥云县人民医院妇科,云南 祥云 672100云南省肿瘤医院/昆明医科大学第三附属医院肿瘤防治办公室,云南 昆明 650118祥云县人民医院妇科,云南 祥云 672100云南省肿瘤医院/昆明医科大学第三附属医院妇科,云南 昆明 650118祥云县人民医院妇科,云南 祥云 672100祥云县人民医院妇科,云南 祥云 672100
医药卫生
宫颈癌认知健康教育自取样人乳头瘤病毒
Cervical cancerAwarenessHealth educationSelf-samplingHPV
《昆明医科大学学报》 2026 (2)
93-100,8
云南省医学学科后备人才培养计划(H-2024010)大理州科技计划项目(20232903B030002)
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