When will the "inflection point" of the decline in cervical cancer mortality come?

Text/Yangcheng Evening News all -media reporter Zhang Hua

Photo/Interviewee provided

The new method of cervical cancer treatment has continued to develop. With the incidence of cervical cancer in my country with an annual average annual growth rate of more than 10%, the mortality of cervical cancer has not declined for more than ten years. On August 13th, at the second gynecological and cancer academic conference of the Guangdong Medical Association, Professor Li Xiaomao, the leader of the Gynecological Division of the Third Hospital of Sun Yat -sen University, said in an interview with reporters that the "inflection point" of the decline in cervical cancer mortality rate has not arrived before arriving. It shows that there are insufficient screening of cervical cancer in my country. At the same time, the treatment level of cervical cancer needs to be improved. The formulation of initial schemes needs to be regulated, and some details in the treatment process need to be improved.

Professor Li Xiaomao, the leader of the Gynecology Department of the Third Hospital of Sun Yat -sen University

Cervical cancer screening mode is insufficient

Cervical cancer is one of the common gynecological tumors for women. According to statistics, in 2020, there are nearly 110,000 new cases of cervical cancer in my country and nearly 60,000 deaths, accounting for 18.3%and 17.6%of the total number of deaths and deaths in the world, respectively. The incidence of cervical cancer in my country has continued to rise, and the gap between rural and cities has gradually narrowed. The average age of cervical cancer is young, especially in rural patients 5 years younger.

Professor Li Xiaomao pointed out, "Over the years, the incidence of cervical cancer in my country has gradually increased, and the mortality rate has not declined. This shows that the screening of cervical cancer is insufficient. Check that the treatment effect of patients in advanced patients is naturally not good, and the prognosis is relatively poor. "

It is understood that my country's cervical cancer screening is currently facing certain challenges. "One of the bottlenecks in cervical cancer screening is the low screen coverage." Professor Li Xiaomao said: "In 2010, the proportion of cervical cancer in our city was only 29%, and the rural areas were only 16%. The proportion of investigations is only 10%. Some women around 60 after menopause think they are old and have no need for screening. Women's self -accepting screening is obviously insufficient. "

In addition, HPV combination cytology is currently the best screening method, but due to the expensive price, it is not included in the national screening project due to expensive price applications. Secondly, the lack of experienced cytologists, the technology of vaginal mirror is not popular, and lack of high -quality screening. This is also the second bottleneck in cervical cancer screening.

Professor Li Xiaomao believes that the number of new cases of reducing the reduction of cervical cancer is the key. If the cervical cancer prevention and control strategy of screening+vaccine is performed, then the goal of eliminating cervical cancer can be accelerated in the near future. At present, three provinces and cities in the country have opened free of charge for women with domestic dual -price HPV vaccines for free. In September this year, Guangdong Province is under 14 years of age with Guangdong Province, newly entered junior high school, and has not been vaccinated by HPV vaccine. Girls can vaccinate domestic dual -price HPV vaccines for free.

Cervical cancer treatment requires MDT and improves the level of homogeneity

At present, the main treatment methods of cervical cancer include surgery, radiotherapy, chemotherapy, etc. With the improvement of cervical cancer diagnosis and treatment technology, there are reports that the five-year survival rate of cervical cancer has increased from 45%from 2003 to 2005 to 60%in 2012-2015 Essence However, it is worth noting that the mortality of cervical cancer in my country has not declined.

In response to the case of cervical cancer, the Gynecological Team of the Third Hospital of Zhongshan

Professor Li Xiaomao believes that this shows that the level of homogeneous chemotherapy of cervical cancer needs to be improved. How to improve the level of cervical cancer treatment in urban and rural homogeneity can relatively concentrate the problems of cervical cancer through the model of the specialized medical community of the specialist league medical consortium.

At the meeting, Professor Li Zhigang, deputy director of the obstetrics and gynecology department of Guangdong Provincial People's Hospital, introduced that cervical cancer MDT (multidisciplinary consultation) diagnosis and treatment model, that is, medical workers in different departments at a specific time and place (can also pass video conferences) discuss For specific patients, each discussioner can independently expands the patient's view of the patient's diagnosis and treatment. The individualized and high -quality diagnosis and treatment plan is formulated through MDT to improve the prognosis of patients, thereby improving the level of diagnosis and treatment of malignant tumors.

In fact, the effectiveness of MDT in cervical cancer diagnosis and treatment has been verified. For example, in 2017, Grover and others introduced the MDT clinic once a week, which can shorten cervical cancer patients from consultation time to treatment time from 108 days to 39 days. Essence It is worth noting that the staging of cervical cancer is the most important part of the diagnosis and treatment process. The National Comprehensive Cancer Network Guide pointed out that the initial treatment of cervical cancer in stage IIB is mainly radiotherapy. The identification of cervical cancer in stage Ⅱb requires gynecologists, radiotherapists and imaging doctors. Because the surgical range of cervical cancer is large, it is easy to damage the ureter -losing tube. During the surgery, you can ask the urologist to place the ureteral stent in advance to prevent ureteral damage. For young cervical cancer patients who are not childbirth and strong fertility, they need to discuss the obstetrics, obstetric tumors, reproductives, and pathology departments to formulate individualized treatment plans.

Professor Li Xiaomao's team performed laparoscopic surgery for cervical cancer

Due to the different medical levels in different regions, there are individual differences between patients, and the best treatment plan for cervical cancer in stage IIB is diverse. Professor Li Zhigang believes that it is certain that the MDT team model will undoubtedly make the diagnosis and treatment of cervical cancer more standardized and individualized.

Source | Yangcheng Evening News · Yangcheng School

Responsible | Niu Zhijie

School pair | He Qiyun

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