探讨首都医科大学附属北京妇产医院1992年1月至2011年12月20年间宫颈癌发病趋势，分析其原因并初步探讨预防措施。

收集1992年1月至2011年12月首都医科大学附属北京妇产医院收治的北京户籍宫颈癌患者1868例的临床病历资料为研究对象。按照年龄，将其分为≤35岁组(n＝286)，36～64岁组(n＝1263)，≥65岁组(n＝319)；按照术后组织病理学类型，将其分为鳞癌组(n＝1654)、腺癌组(包括腺鳞癌，n＝186)及其他组(n＝28)；按照发病年份，将其分为1992－1996年组(n＝178)，1997－2001年组(n＝373)，2002－2006年组(n＝563)，2007－2011年组(n＝754)；按照国际妇产科联盟(FIGO)对宫颈癌的临床分期，又分为Ⅰ期组(n＝667)，Ⅱ期组(n＝721)，Ⅲ期组(n＝466)，Ⅳ期组(n＝14)。上述各分组患者一般情况比较，差异均无统计学意义(P>0.05)(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准，得到该委员会批准)。采用回顾性分析法，从发病年龄、临床分期、组织病理学类型等方面分析本院20年间宫颈癌发病趋势。

≤35岁组患者年龄组构成比从1992－1996年的7.30%上升到2007－2011年的16.05%，但两者比较，差异无统计学意义(χ²＝21.598，P<0.05)；≥65岁组中宫颈癌发病率呈下降趋势，由1992－1996年的30.34%下降到2007－2011年的11.54%，两者比较，差异有统计学意义(χ²＝57.600，P<0.05)。其余年龄组宫颈癌发病率未见明显升高或下降趋势。不同发病年份组中宫颈腺癌所占比例未见明显变化，年轻患者宫颈腺癌发病率虽呈逐年上升趋势，从1992－1996年的8.90%上升至2007－2011年的22.64%，但两者比较，差异无统计学意义(P>0.05)。各年龄组中Ⅰ期宫颈癌所占比例均呈上升趋势，Ⅱ，Ⅲ期宫颈癌呈下降趋势。≤35岁组中以Ⅰ，Ⅱ期宫颈癌为主，约占90%，其中Ⅰ期宫颈癌所占比例从1992－1996年的23.01%逐步上升到2007－2011年的57.03%；≥65岁组中，虽Ⅰ期宫颈癌患者呈上升趋势，Ⅲ期患者呈逐步下降趋势，但仍以Ⅱ，Ⅲ期患者为主，所占比例由1992－1996年的92.59%下降至2007－2011年的79.32%。

20年间宫颈癌发病呈年轻化趋势，年轻宫颈癌患者确诊时多为早期，而≥65岁宫颈癌患者确诊时则以Ⅱ，Ⅲ期为主。宫颈腺癌发病率在年轻患者中呈上升趋势。

To analyze the change tendency of cervical cancer in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from 1992 to 2001.

The clinical and pathological data of 1868 patients with cervical cancer form January 1992 to December 2011 were retrospectively analyzed. All the patients were Beijing native inhabitants. They were divided into three groups according to age, ≤ 35 years old (n=286), 36-64 years old (n=1263), ≥64 years old (n=319). They were further divided into 3 groups according to histopathology, squamous carcinoma (SC) group (n=1654), adenocarcinoma group (n=186) and other types group (n=28). They were divided into 4 groups again according to different years, 1992-1996 group (n=178), 1997-2001 group (n=373), 2002-2006 group (n=563), 2007-2011 group (n=754). At the same time, they were divided into 4 groups according to different clinical stages, stage Ⅰ (n=667), stage Ⅱ (n=721), stage Ⅲ (n=466), stage Ⅳ (n=14). The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Beijing Obstetrics and Gynecology Hospital, Capital Medical University.

The average age of cervical cancer gradually decreased over the past 20 years, form (56.67±13.29) years old in the year of 1992-1996 to (46.06±10.38) years old in the year of 2007-2011. Constituent ratio of the young patients (≤35 years old) increased dramatically form 7.30% in the year of 1992-1996 to 16.05% in the year of 2007-2011, with the significant difference (χ²=21.598, P<0.05). Constituent ratio of the old patients(≥65 year old) decreased from 30.34% in the year of 1992-1996 to 11.54% in the year of 2007-2011, with significant difference (χ²=57.600, P<0.05). Other age groups showed no obvious changes. In young patients, the constituent ratio of cervical adenocarcinoma increased from 8.90% in the year of 1992-1996 to 22.64% in the year of 1997-2011, but there had no statistically significant difference (P>0.05). The ratio of stage Ⅰ cervical cancer steadily increased and stages Ⅱ-Ⅲ decreased correspondingly in all age groups. In young patients, stages Ⅰ-Ⅱconstituted about 90% of the cervical cancer, stage Ⅰincreased from 23.01% in the year of 1992-1996 to 57.03% in the year of 2007-2011. In old patients, stages Ⅱ-Ⅲ cervical cancer accounted for 92.59% in the year of 1992-1996 and 79.32% in the year of 2007-2011.

The prevalence of cervical carcinoma tended to be younger. Early clinical stage was the main type in the young patients with cervical carcinoma. Women older than 65 years old made up a significant proportion of cervical cancer, and presented with a later stage at diagnosis.