Comparative Analysis of Cervical Cancer Screening Results from 2019 to 2021 in Shihezi City, Xinjiang Uyghur Autonomous Region

Abstract

Background Cervical cancer (CC) is one of the common malignant tumors that poses a threat to female health. The screening and prevention strategies of CC vary in different regions. The economic and cultural levels in the Xinjiang region differ significantly from those in other areas. It is of practical significance to identify CC screening efficacy in this region, thus favoring the modification of CC screening program. Objective To compare and analyze the CC screening results in Shihezi city, Xinjiang Uyghur Autonomous Region from 2019 to 2021, and to understand the distribution of high-risk human papillomavirus (hrHPV) infection and the changes in cervical lesion detection in this region. Methods CC screening in Shihezi city was conducted in a three-year interval. We retrospectively collected the screening data of 68 300 women from 2019 to 2021, who underwent hrHPV-based screening in the First Affiliated Hospital of Shihezi University, Shihezi City People's Hospital, and Shihezi Maternal and Child Health Hospital. The distribution of hrHPV infection and the changes in cervical lesion detection from 2019 to 2021 were compared and analyzed. Results A total of 18 378, 28 616 and 21 306 individuals were screened for CC in 2019, 2020 and 2021, respectively. The hrHPV-positive rate in 2021 and 2022 was significantly lower than that in 2019 [9.90% (2 109/21 306) vs 9.13% (2 612/28 616) vs 15.32% (2 816/18 378), P<0.017]. The hrHPV 52 type and hrHPV 16 type had the highest positive rates for three consecutive years in Shihezi city. The rate of thin-layer cytology (TCT) examination for non-HPV 16/18 types in 2021 and 2020 was significantly higher than that in 2019 [88.61% (1 502/1 695) vs 74.70% (1 559/2 087) vs 48.90% (1 090/2 229), P<0.017]. Among women who underwent vaginal colposcopy, the positive pathology rate of LSIL (low-grade squamous intraepithelial lesion) and above was the highest in 2021 [52.80% (217/411) ], followed by that in 2020 [41.42% (239/577) ] and the lowest in 2019 [28.53% (107/375) ] (P<0.017) . Conclusion The hrHPV-positive rate in Shihezi city, Xinjiang Uyghur Autonomous Region showed certain decline from 2019 to 2021, but hrHPV 52 type and hrHPV 16 type remained the main infection types. Since the initiation of CC screening in 2019, the hrHPV-positive rate has decreased from 15.32% to 9.90%, the TCT examination rate has increased from 48.90% to 88.61%, and the positive rate of cervical lesion detection of LSIL and above has increased from 28.53% to 52.80% from 2019 to 2021. There have been significant improvements in the completion rate of CC screening and the detection rate of cervical lesions.

Keywords

• cervical cancer|human papillomavirus|shihezi city|vaginal colposcopy|screening results|follow-up management