SINGLE VISIT CERVICAL CANCER PREVENTION PROGRAM

单次宫颈癌预防计划

• 批准号: 6376602
• 负责人: ALBERTO MANETTA
• 金额: $ 42.46万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-01 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6376602
• 关键词: South American; behavioral /social science research tag; cancer prevention; caucasian American; cervical /vaginal smear; cervix neoplasms; clinical research; clinical trials; culture; cytology; health behavior; health care policy; health services research tag; human subject; human therapy evaluation; hyperthermia therapy; longitudinal human study; medical appointment; neoplasm /cancer diagnosis; neoplasm /cancer surgery; neoplasm /cancer thermotherapy; outcomes research; patient care management; preneoplastic state; racial /ethnic difference; socioeconomics; women's health

DESCRIPTION (Applicant's Description) The barriers to cervix cancer screening and management are well described. A significant barrier to the diagnosis and management of cervical cancer is the loss to follow-up for those who undergo screening using the Pap smear. In addition, other barriers include lack of education, cultural-based attitudes and health behaviors, as well as, socioeconomic factors. We believe that the usual approach to cervix cancer screening diagnosis and management accentuates problems due to loss to follow-up and these barriers. The goal of this project is to implement and evaluate an innovative cancer control program that could revolutionize the approach to cervix cancer prevention. The study will determine the effectiveness of a single-visit program (SVP), including the diagnosis and treatment of patients with premalignant conditions, in decreasing the rate of loss to follow-up of women with abnormal Pap smears in comparison to a Usual Care Program (UCP). If successful, the proposed program will markedly decrease the proportion of women who have positive Pap smears and are lost to follow-up and thereby decrease the rates of invasive cervix cancer. Moreover, the program could be transported to communities in the United States and to other countries around the world where the incidence and mortality rates of this malignancy are increased. We have previously demonstrated the feasibility of a single-visit approach in a pilot study completed by our group that indicates that our approach is promising for the secondary prevention and control of cervix cancer The single-visit program (SVP) consists of an initial screening of patients with pelvic exams and Pap smears with immediate cytological analysis by a cytopathologist. All patients receive the results of their Pap smears during the visit. In addition, patients found to have severe cervix dysplasia undergo diathermy loop excision (DLE) of the transformation zone during the same visit. By combining immediate cytologic screening and DLE in the same visit, most barriers to follow-up for patients with cervix dysplasia can be overcome. The specific aims of this proposal are: 1) implement and evaluate a single-visit program for cervix cancer prevention in clinics serving a multi-ethnic population of women; 1a) standardize the operating procedures regarding recruitment plans, personnel, patient flow patterns, and follow-up plans; 1b) set up an efficient system for Pap smear interpretation for patients in the SVP that will minimize waiting time; and, c) recruit 3,520 women (Hispanic and Non-Hispanic White women) and randomize them into the SVP or a usual care program (UCP); and, 2) evaluate the SVP in terms of follow-up rates for abnormal Pap smears, patient satisfaction, and cost-effectiveness.

申请人的描述（Applicant's Description） 宫颈癌筛查和管理的障碍得到了很好的描述。 宫颈癌的诊断和治疗的一个重要障碍是 接受巴氏涂片筛查的人失去随访。 此外，其他障碍包括缺乏教育、文化基础 态度和健康行为，以及社会经济因素。 我们 我认为，通常的方法，以子宫颈癌筛查诊断和 由于失访和这些障碍，管理层加剧了问题。 该项目的目标是实施和评估一种创新的癌症 控制计划，可以彻底改变宫颈癌的方法 预防 该研究将确定单次访视的有效性 计划（SVP），包括诊断和治疗患者 癌前病变，降低失访率， 子宫颈抹片检查异常的妇女与子宫颈护理计划（UCP）相比。 如果成功的话，该计划将大大减少 子宫颈抹片检查呈阳性且失访的妇女， 降低宫颈癌的发病率。 此外，该计划可以 运送到美国和其他国家的社区 这种恶性肿瘤的发病率和死亡率 增加了。 我们以前已经证明了一种 在我们小组完成的一项试点研究中， 我们的方法对于二级预防和控制 子宫颈癌单次访视计划（SVP）包括初始 对患者进行盆腔检查和巴氏涂片筛查， 由细胞病理学家进行细胞学分析。 所有患者都能收到结果 他们的子宫颈抹片检查 此外，患者发现， 严重的子宫颈发育不良接受透热环切除术（DLE）的 在同一个访问期间的转换区。 结合即时细胞学检查 在同一次访视中进行筛查和DLE，患者随访的大多数障碍 子宫颈发育不良可以克服。 本提案的具体目标 实施和评估宫颈癌一次性就诊方案 在为多族裔妇女服务的诊所开展预防工作; 1a） 规范招聘计划、人员、 病人流动模式和后续计划; 1b）建立一个有效的系统 对于SVP患者的巴氏涂片判读， 等待时间; c）招募3 520名妇女（西班牙裔和非西班牙裔白色 女性），并将其随机分配到SVP或常规护理计划（UCP）中;以及， 2)根据异常巴氏涂片的随访率评价SVP， 患者满意度和成本效益。