Analysis of Results from AI-Assisted Cervical Cancer Screening for Rural Women in Baoding City
-
摘要:
目的 分析保定市2021年人工智能宫颈癌筛查项目的筛查数据,了解保定市人工智能辅助宫颈癌筛查效果及存在问题,为改进农村妇女人群宫颈癌防治工作提供依据。 方法 收集2021年保定市3个县宫颈癌筛查的35~64岁农村已婚妇女筛查资料,分析癌前病变和宫颈癌筛查情况。 结果 人工智能辅助宫颈癌筛查中细胞学阳性人数为863例,阳性检出率为7.94%。此外,542例细胞学阳性的妇女接受了阴道镜检查,结果显示低度病变18例,高度病变20例,宫颈癌1例。保定市三个县2019,2020,2021年的AUSCS+、低度病变和高度病变检出率差异有统计学意义(χ2 = 858.90,P < 0.001;χ2 = 14.28,P = 0.003;χ2 = 10.75,P = 0.013)。 结论 人工智能在宫颈癌筛查项目工作有一定的作用,但是还存在异常病例失访较多等问题,保定市宫颈癌的筛查防控工作有待进一步改进提高。 -
关键词:
- 宫颈肿瘤 /
- 宫颈癌筛查 /
- 农村妇女 /
- 保定市 /
- 人工智能辅助细胞学系统
Abstract:Objective To analyze the data of the artificial intelligence cervical cancer screening project in Baoding in 2021, understand the effect and existing problems of cervical cancer screening in Baoding, and provide a basis for improving the prevention and treatment of cervical cancer in the rural women population. Methods Screening data for married rural women aged 35-64 from three counties in Baoding City in 2021 were collected, and the data of precancerous lesions and cervical cancer screening was analyzed. Results The results show that artificial intelligence-assisted cervical cancer screening identified 863 cases of positive cytology, with a positivity rate of 7.94%. Additionally, 542 women with positive cytology underwent colposcopy, which revealed 18 cases of low-grade lesions, 20 cases of high-grade lesions, and 1 case of cervical cancer. There were statistically significant differences in the detection rates of AUSCS+, low-grade lesions, and high-grade lesions across three counties in Baoding from 2019 to 2021 (χ2 = 858.90, P < 0.001; χ2 = 14.28, P=0.003; χ2 = 10.75, P = 0.013). Conclusion The artificial intelligence cervical cancer screening project has shown some success, but there are still issues like a high rate of missed abnormal cases. The screening and prevention efforts for cervical cancer in Baoding City need further improvement. -
表 1 2019-2021年保定市农村妇女宫颈细胞学和阴道镜检查情况分析
Table 1. Analysis of cervical cytology and colposcopy examination of rural women in baoding city from 2019 to 2021
年份宫颈细胞学 阴道镜 检查
例数阳性
例数阳性率
(%)检查
例数异常
例数异常率
(%)2019 15993 471 2.95% 406 23 5.67 2020 14547 346 2.38% 303 22 7.26 2021(上) 8299 74 0.89% 64 10 15.63 2021(下) 10865 863 7.94% 542 39 7.20 表 2 2021年7-12月保定市农村妇女宫颈细胞学筛查阳性率
Table 2. Positive rate of cervical cytology Screening among rural women in baoding city from July to December 2021
年龄段(岁) 检查人数 阳性率(%) 35~44 3650 7.86%(287) 45~54 4452 8.65%(385) 55~64 2763 6.91%(191) χ2 1486.05 P <0.001 表 3 2019-2021年保定地区农村妇女筛查和阴道镜活检后组织病理资料[n(%)]
Table 3. Screening and histopathological data from cervical biopsies of rural women in baoding region (2019−2021) [n(%)]
筛查情况 2019(n = 15993 )2020(n = 14547 )2021上(n = 8299 )2021下(n = 10865 )χ2 P AUS-CS+ 471(2.95) 346(2.38) 74(0.89) 863(7.94) 858.90 0.001* 低度病变 10 62.53/10万 7 48.12/10万 4 48.20/10万 18 169.08/10万 14.28 0.003* 高度病变 62. 53/10万 15 103.11/10万 6 72.30/10万 20 187.86/10万 10.75 0.013* 宫颈癌 3 18.76/10万 0 0 0 0 1 9.39/10万 4.12 0.248 *P < 0.05。 -
[1] Small W,J R,Bacon M A,Bajaj A,et al. Cervical cancer: A global health crisis[J]. Cancer,2017,123(13):2404-2412. doi: 10.1002/cncr.30667 [2] SUNG H,FERLAY J,SIEGEL R L,et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J,2021,71:209-249. doi: 10.3322/caac.21660 [3] 任文辉,赵雪莲,赵方辉. 全球宫颈癌筛查指南制定现状的系统综述[J]. 中华医学杂志,2021,101(24):1882-1888. [4] 魏丽惠. 子宫颈癌筛查——从细胞学检查到HPV检测[J]. 中华妇产科杂志,2019,54(5):289-292. doi: 10.3760/cma.j.issn.0529-567x.2019.05.001 [5] 李娜,钱立杰,代聪伟,等. 2015-2017年衡水地区农村妇女宫颈病变筛查情况分析[J]. 现代预防医学,2021,48(21):3861-3865. [6] Bao H,Bi H,Zhang X,et al. Artificial intelligence-assisted cytology for detection of cervical intraepithelial neoplasia or invasive cancer: A multicenter,clinical-based,observational study[J]. Gynecol Oncol,2020,159(1):171-178. doi: 10.1016/j.ygyno.2020.07.099 [7] 夏昌发,乔友林,张勇,等. WHO全球消除宫颈癌战略及我国面临的挑战和应对策略[J]. 中华医学杂志,2020,100(44):3484-3488. doi: 10.3760/cma.j.cn112137-20200909-02606 [8] Luo X,Song L,Wu J,et al. Analysis of the reported data of national rural cervical cancer screening project from 2012 to 2013,China[J]. Chinese Journal of Preventive Medicine,2016,50:346-350. [9] Turkish Cervical Cancer and Cervical Cytology Research Group. Prevalence of cervical cytological abnormalities in Turkey[J]. Int J Gynaecol Obstet,2009,106(3):206-209. doi: 10.1016/j.ijgo.2009.04.003 [10] Senkomago V,Royalty J,Miller J W,et al. Cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in four US-Affiliated Pacific Islands between 2007 and 2015[J]. Cancer Epidemiol,2017,50:260-267. doi: 10.1016/j.canep.2017.04.011 [11] 罗庆,汪文慧,樊利春,等. 2014-2018年海南省基于细胞学初筛农村妇女宫颈癌结果分析[J]. 现代预防医学,2020,47(20):3720-3723. [12] 商广洁,董燕,张玉萍,等. 2012-2017年山西省农村妇女宫颈癌筛查结果分析[J]. 中国肿瘤,2020,29(6):425-429. doi: 10.11735/j.issn.1004-0242.2020.06.A004 [13] 胡林凤,黄朝辉,张悦,等. 2015—2019 年安徽省农村妇女宫颈癌筛查结果分析[J]. 现代预防医学,2021,48(20):3729-3732. [14] Bao H,Sun X,Zhang Y,et al. The artificial intelligence-assisted cytology diagnostic system in large-scale cervical cancer screening: A population-based cohort study of 0.7million women[J]. Cancer Med,2020,9(18):6896-6906. doi: 10.1002/cam4.3296 [15] 武丽,李兵,吴云涛,等. 广东省农村妇女宫颈癌前病变及宫颈癌影响因素分析[J]. 现代预防医学,2019,46(19):3509-3513. [16] Castle P E,Sideri M,Jeronimo J,et al. Risk assessment to guide the prevention of cervical cancer [J]. American Journal of Obstetrics and Gynecology,2007,197(4): 356. e351-356. e356. [17] 刘香,欧阳雪. 液基与传统巴氏细胞学在宫颈病变筛查中的对比分析[J]. 中外医疗,1013,23:188-189. [18] 赵艳霞,马兰,任文辉,等. 2009-2018年中国农村妇女宫颈癌检查项目数据分析[J]. 中华医学杂志,2021,101(24):1863-1868. [19] Participatory innovation for human papillomavirus screening to accelerate the elimination of cervical cancer [J]. Lancet,2021,9: e582-e583.