Background/Objectives:Since 2020, Germany has replaced its annual cytological screening for cervical cancer in women aged 35 and older with a combination screening program. This updated protocol, conducted every three years, includes both a cervical Pap smear and an HPV (human papillomavirus) test. In addition, the 2020 update of the German Cervical Cancer Screening Program mandates a more timely follow-up for certain abnormal findings compared to the previous approach.Methods: Results of cytologic, colposcopic, and histologic examinations between 2018 and 2021 were retrospectively retrieved from the electronic patient records of the Institute of Pathology Saarbrücken Rastpfuhl in order to present relevant findings within the years 2018–2019 and 2020–2021. The present study included all women who received appropriate follow-up based on the corresponding underlying screening modality.Results: Our reporting considered data from 30,715 women in 2018/19 (prior screening modality group) and 25,924 women in 2020/21 (updated screening modality group). In 2018/19, a total of 93 histological examinations were performed, compared to 237 in 2020/21. In 2018/19, 52 cases of CIN III and 12 cases of CIN II were identified, while in 2020/21, 78 cases of CIN III and 31 cases of CIN II were detected. In contrast, while women with negative cytological findings in 2018/19 were typically not referred for further colposcopic or histological evaluation, the updated program enabled earlier detection and treatment of cases with diagnosed high-grade dysplasia based solely on a positive HPV test. Notably, 31 women who were diagnosed at an earlier stage based solely on a positive HPV test initially presented with a cytological Pap I result (negative for intraepithelial lesion or malignancy; NILM).Conclusions: Additional HPV co-testing within the updated German cervical cancer screening program resulted not only in high rates of high-grade dysplasia detection but also a rise in the number of colposcopic procedures. While negative follow-up HPV findings regularly showed remission of the original finding, incidence of high-grade dysplasia was usually linked to a positive HPV test.
背景/目的：自2020年起，德国对35岁及以上女性的宫颈癌筛查方案进行了更新，将原有的年度细胞学筛查调整为联合筛查模式。该更新方案每三年实施一次，同时包含宫颈巴氏涂片和人乳头瘤病毒（HPV）检测。此外，2020版德国宫颈癌筛查指南要求对特定异常结果采取较既往方案更为及时的随访措施。 方法：本研究回顾性提取萨尔布吕肯拉斯特普尔病理研究所2018年至2021年间的细胞学、阴道镜及组织学检查结果，以呈现2018-2019年与2020-2021年两个阶段的相关发现。研究纳入了所有根据相应筛查方案接受规范随访的女性患者。 结果：研究数据涵盖2018/19年度（传统筛查组）30,715名女性及2020/21年度（更新筛查组）25,924名女性。2018/19年度共进行93例组织学检查，而2020/21年度增至237例。在病理诊断方面，2018/19年度检出52例宫颈上皮内瘤变III级（CIN III）和12例CIN II，2020/21年度则发现78例CIN III和31例CIN II。值得注意的是，2018/19年度细胞学阴性者通常未转诊进行阴道镜或组织学评估，而更新方案使得仅凭HPV阳性结果即可对高级别上皮内病变实现早期诊断与治疗。特别需要指出的是，31例仅通过HPV阳性在早期获得诊断的女性，其初始细胞学检查结果均为巴氏I级（未见上皮内病变或恶性细胞）。 结论：德国更新版宫颈癌筛查方案中增加的HPV联合检测不仅显著提高了高级别上皮内病变的检出率，同时也增加了阴道镜检查的实施数量。虽然HPV随访阴性者通常显示原有病变消退，但高级别上皮内病变的发生多与HPV检测阳性相关。
肿瘤(癌症)患者之家