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COVID-19 大流行时代的宫颈癌预防。

Cervical Cancer Prevention in the Era of the COVID-19 Pandemic.

机构信息

Medicover Sp. zo.o, Aleje Jerozolimskie 96, 00-807 Warsaw, Poland.

Department of Oncologic Gynecology and Obstetrics, The Center of Postgraduate Medical Education, 00-416 Warsaw, Poland.

出版信息

Medicina (Kaunas). 2022 May 29;58(6):732. doi: 10.3390/medicina58060732.

Abstract

: Cervical cancer (CC) is the fourth most common cause of cancer-related morbidity and mortality among women worldwide. CC prevention is based on screening and HPV vaccination. The COVID-19 pandemic has caused difficulties in implementing CC-preventative measures. The aim of this study was to collect data on the implementation of CC prophylaxis in Poland provided by public and private health care with a particular focus on the impact of the COVID-19 pandemic and attempt to estimate the level of CC-screening implementation by 2026 under public and private health care. : Data on the implementation of privately funded (2016-2021) and publicly funded (2014-2021) CC-preventative measures in Poland were examined. The Prophet algorithm, which positions itself as an automatic forecasting procedure and represents a local Bayesian structural time-series model, was used to predict data. The correlation test statistic was based on Pearson's product moment correlation coefficient and follows a t distribution. An asymptotic confidence interval was given based on Fisher's Z transform. : In 2021, a significantly higher population screening coverage was observed in private health care (71.91%) than in the public system (12.6%). Our estimation assumes that the adverse downward trend of population coverage (pap smear CC screening) in the public system will continue to 5.02% and in the private health system to 67.92% in 2026. Correlation analysis showed that with the increase in the sum of HPV tests and LBC, the percentage of Pap smear coverage in the private healthcare sector decreases r = -0.62, = 0.260 df = 3, CI = [-0.97, 0.57]. The amount of HPV vaccinations provided in private health care is steadily increasing. Immunization coverage of the population of girls aged 9-18 years under private health care at the end of the observation period was 4.3% (2021). : It is necessary to reorganize the public CC-screening system in Poland based on a uniform reporting system for tests performed in both public and private health care using the model of action proposed by us. We recommend the introduction of a national free HPV vaccination program funded by the government and implemented in public and private health care facilities.

摘要

宫颈癌(CC)是全球女性癌症相关发病率和死亡率的第四大主要原因。CC 的预防基于筛查和 HPV 疫苗接种。COVID-19 大流行给 CC 预防措施的实施带来了困难。本研究的目的是收集波兰公共和私人医疗保健机构实施 CC 预防的数据,特别关注 COVID-19 大流行的影响,并尝试估计 2026 年公共和私人医疗保健机构的 CC 筛查实施水平。

研究方法

检查了波兰私人(2016-2021 年)和公共(2014-2021 年)资助的 CC 预防措施的实施数据。 Prophet 算法被用作自动预测程序,代表局部贝叶斯结构时间序列模型,用于预测数据。相关测试统计量基于 Pearson 乘积矩相关系数,并遵循 t 分布。基于 Fisher 的 Z 变换给出了渐近置信区间。

研究结果

2021 年,私人医疗保健的人群筛查覆盖率(71.91%)明显高于公共系统(12.6%)。我们的估计假设,公共系统中人群覆盖率(巴氏涂片 CC 筛查)的不利下降趋势将继续,到 2026 年将降至 5.02%,而在私人医疗保健系统中降至 67.92%。相关分析表明,随着 HPV 检测和 LBC 总和的增加,私人医疗保健部门巴氏涂片覆盖率的百分比降低 r = -0.62, = 0.260 df = 3,CI = [-0.97,0.57]。私人医疗保健提供的 HPV 疫苗接种数量稳步增加。在观察期结束时,私人医疗保健下 9-18 岁女孩的人群免疫覆盖率为 4.3%(2021 年)。

研究结论

有必要根据我们提出的行动模式,基于公共和私人医疗保健中进行的检测的统一报告系统,对波兰的公共 CC 筛查系统进行重组。我们建议引入政府资助并在公共和私人医疗保健机构实施的全国免费 HPV 疫苗接种计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25ac/9229337/e33f32d994d1/medicina-58-00732-g001.jpg

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