BACKGROUND Uterine cervical cancer is the fourth most common female cancer in the world. In Japan, we have an apparently low rate of joining cervical cancer screening programs compared with Western countries. Furthermore, the incidence and mortality rate of cervical cancer among the younger generation has been increasing. OBJECT The aim of this study was to assess the effectiveness of cervical cancer screening with human papillomavirus (HPV) testing and cytology in Japan. METHODS Collaborating with Saga City government, we initiated a cervical cancer screening system consisting of HPV testing and baseline cervical cytology from April 2011 as a social experiment. A total of 17,284 participants have been screened with this new combination system. RESULTS After HPV testing with cytology-based cervical cancer screening, the number of screenings done in women aged under 40 years has significantly increased. In addition, the number of women diagnosed with cervical intraepithelial neoplasia grade 3 has increased (25 of 14,025 vs. 146 of 23,049 under 50 years: p < 0.001). CONCLUSION These data suggested that the introduction of HPV testing with cytology-based cervical cancer screening as an adjunct to conventional cytology resulted in better efficiency and more accurate screening among the Japanese population.

中文翻译：

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自从在日本基于细胞学的宫颈癌筛查系统引入人类乳头瘤病毒测试以来发生了什么变化社会实验。

背景技术子宫宫颈癌是世界上第四大最常见的女性癌症。在日本，与西方国家相比，加入子宫颈癌筛查计划的比率明显较低。此外，在年轻一代中子宫颈癌的发病率和死亡率一直在增加。目的本研究的目的是评估日本使用人乳头瘤病毒（HPV）检测和细胞学检查宫颈癌筛查的有效性。方法从2011年4月开始，我们与佐贺市政府合作，启动了一项由HPV检测和基线宫颈细胞学检查组成的宫颈癌筛查系统，作为一项社会实验。这个新的组合系统筛选了总共17,284名参与者。结果在通过基于细胞学的子宫颈癌筛查进行HPV测试后，在40岁以下的女性中进行筛查的次数已大大增加。此外，被诊断患有3级宫颈上皮内瘤变的女性人数有所增加（50岁以下的女性为25,140名，而23岁的女性为146名，而23岁的女性为40名：p <0.001）。结论这些数据表明，将HPV检测与基于细胞学的宫颈癌筛查结合起来作为常规细胞学的辅助手段，可在日本人群中实现更高的效率和更准确的筛查。