An Audit of the Cervical Cancer Screening Histories of 246 Women With Carcinoma
An Audit of the Cervical Cancer Screening Histories of 246 Women With Carcinoma
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DOI：
10.1097/lgt.0b013e31823da811
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发表时间：
2012-07-01
影响因子：
3.7
通讯作者：
Nation, Jill
中科院分区：
文献类型：
--
作者：
Duggan, Maire A.;Nation, Jill
客观的。对 1996 年至 2001 年间居住在卡尔加里卫生区的患有宫颈癌的女性进行了审计，以确定导致筛查失败的机会性宫颈癌筛查途径中的因素。材料和方法。该队列由 246 名女性组成。有关巴氏涂片检查和阴道镜/妇科检查的信息是从卡尔加里实验室服务的文件及其阴道镜/癌症中心治疗图表中获得的。定义筛选失败因素并计算频率。结果。筛查失败因素如下：（1）41例（16.7%）未进行筛查，即未进行巴氏试验筛查； (2) 29例(11.8%)未筛查，即诊断后12个月内未进行巴氏涂片检查； (3) 28例(13.7%)样本不足，即巴氏试验结果为阴性； (4) 34人(13.8%)没有转诊阴道镜/妇科检查，和/或延迟超过3个月； (5) 18名(13.2%)延迟转诊检查非典型腺细胞高级鳞状上皮内病变和更高级别的巴氏涂片检查超过3个月； (6)漏诊73例(55.3%)，即阴道镜检查诊断小于恶性。漏报的巴氏试验和延迟的巴氏试验报告无法得到充分调查，但有限的证据表明漏报导致了一些失败。结论。如果该地区的宫颈癌预防计划要更加有效，除了细胞学筛查招募之外的因素需要有针对性的改进。
Objective. Women with cervical carcinoma and residing in the Calgary Health Region between 1996 and 2001 were audited to characterize factors in the opportunistic cervical cancer screening pathway contributing to screening failures.Materials and Methods. The cohort consisted of 246 women. Information on their Pap tests and colposcopic/gynecologic examinations was obtained from the files of Calgary Laboratory Services and their colposcopic/cancer center treatment charts. Screening failure factors were defined, and frequencies were calculated.Results. Screening failure factors were as follows: (1) 41 (16.7%) were not screened, that is, no Pap test screening; (2) 29 (11.8%) were underscreened, that is, no Pap test within 12 months of diagnosis; (3) 28 (13.7%) were undersampled, that is, the Pap test result was negative; (4) 34 (13.8%) had no referral for a colposcopy/gynecology examination, and/or it was delayed for more than 3 months; (5) 18 (13.2%) had delayed referral for examination of an atypical glandular cell high-grade squamous intraepithelial lesion and higher Pap test for more than 3 months; and (6) 73 (55.3%) were underdiagnosed, that is, the diagnosis in colposcopy examination was less than malignant. Underreported Pap tests and delayed Pap test reporting could not be fully investigated, but limited evidence suggested that underreporting contributed to some failures.Conclusions. Factors other than recruitment to cytological screening need targeted improvement if the region's cervical cancer prevention program is to be more effective.