Timing of Colposcopy After Cervical Cytologic Abnormalities
Timing of Colposcopy After Cervical Cytologic Abnormalities
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DOI：
10.1097/aog.0b013e3181cec0b5
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发表时间：
2010-03-01
影响因子：
7.2
通讯作者：
Richardson, Lisa C.
中科院分区：
文献类型：
--
作者：
Kuo, Tzy-Mey;Benard, Vicki B.;Richardson, Lisa C.
目的：研究低度鳞状上皮内病变(Lsil)、不典型鳞状细胞不能排除高度鳞状上皮内病变(Asc-H)或高度鳞状上皮内病变(HSIL)的Pap试验结果异常的妇女从筛查到阴道镜随访的时间长度。方法：我们在2004年从美国一家大型医疗机构的医疗保险索赔中利用LsIL、HSIL或ASC-H的指数Pap试验结果确定了4,824名年龄在18岁至之间的女性，并进行了常规的Pap试验。结果：从巴氏试验异常到阴道镜检查的预期时间因年龄和巴氏试验结果不同而不同。对于ASC-H结果为阳性的女性，与年轻女性相比，年龄较大的女性更有可能推迟阴道镜检查。对于LSIL和HSIL结果阳性的女性，阴道镜检查的时间没有年龄差异；但与ASC-H相比，阴道镜检查的时间更短。我们发现，医生的专业、医疗保健环境以及地区层面的种族和民族密度与在巴氏指数试验结果异常后接受随访的时间相关。结论：患有LSIL和HSIL的女性在3-4个月内接受阴道镜检查，而ASC-H的女性更有可能在以后接受手术。(Obstet Gyneol 2010；115：629-36)
OBJECTIVE: To examine the length of time from Pap test (index Pap) screening to follow-up colposcopy for women with abnormal Pap test results of low-grade squamous intraepithelial lesions (LSIL); atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (ASC-H); or high-grade squamous intraepithelial lesions (HSIL).METHODS: We identified 4,824 women aged 18 to 64 years with the index Pap test results of LSIL, HSIL, or ASC-H from health insurance claims in a large U. S. health care organization and who had a routine Pap test in 2004. We used a survival regression model to estimate factors related to the length of time (days) from the index Pap test to a follow-up colposcopy.RESULTS: The expected length of time from an abnormal Pap test to a colposcopy differed by age and Pap test result. For women with an ASC-H result, those who were older were more likely to delay colposcopy compared with the younger women. For women with LSIL and HSIL results, the timing of colposcopy did not differ by age; however, the time was shorter compared with ASC-H. We found that physician specialties, health care settings, and area-level racial and ethnic density were related to timing of receiving follow-up procedures after an abnormal index Pap test result.CONCLUSION: Women with LSIL and HSIL received a colposcopy in 3-4 months, but women with ASC-H were more likely to receive the procedure at a later time. (Obstet Gynecol 2010;115:629-36)