Gynecological care of elderly women. Another look at Papanicolaou smear testing.
Gynecological care of elderly women. Another look at Papanicolaou smear testing.
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老年妇女的妇科护理。
DOI：
10.1001/jama.1986.03380030069030
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
M. Wistreich
中科院分区：
文献类型：
--
作者：
J. Mandelblatt;I. Gopaul;M. Wistreich
在实施积极的巴氏涂片筛查计划的国家，宫颈癌死亡率正在下降。然而，老年女性很可能终生不使用或未充分使用巴氏筛查，并且老年女性的死亡率并未下降。许多研究指出，与至少接受过一次筛查的女性相比，未参加巴帕尼科拉乌筛查的女性在接受筛查时宫颈癌的发病率高出 2.7 至 4 倍。在初级保健机构为 1542 名老年妇女提供了妇科筛查； 75% 的女性之前没有接受过定期筛查，25% 的女性从未接受过筛查。这些女性中有一半选择参加我们的筛查计划。该组的总体患病率为每 1000 份异常巴氏涂片中 13.5 例（95% 置信区间，5.6 至 21.4）。年龄、种族、既往筛查史和异常妇科症状无法预测巴氏涂片异常的女性。我们的结果表明，如果女性之前未接受定期筛查，则宫颈癌筛查应持续到 65 岁以上。
Mortality from cervical cancer is decreasing in countries where aggressive Papanicolaou smear screening programs are in place. However, elderly women are likely to be lifelong nonusers or underusers of Papanicolaou screening, and mortality has not declined for older women. Many studies have noted that nonparticipants in Papanicolaou screening have a 2.7 to four times greater incidence of cervical cancer when they are screened compared with women who have been screened at least once. Gynecological screening was offered to 1542 elderly women in a primary care setting; 75% of the women had not had regular prior screening and 25% had never been screened. Half of these women chose to participate in our screening program. An overall prevalence rate of 13.5 per 1000 abnormal Papanicolaou smears (95% confidence interval, 5.6 to 21.4) was noted in the group. Age, race, prior screening history, and abnormal gynecological symptoms failed to predict the women who would have abnormal Papanicolaou smears. Our results suggest that cervical cancer screening should continue beyond 65 years of age if women have not received regular prior screening.