Schenck U, von Karsa L
Labor für Klinische Zytologie, Institut für Allgemeine Pathologie and Pathologische Anatomie, TU München and Cytological Institute of the Bavarian Cancer Society, Postbox 800 411, 81 604, Munich, Germany.
Eur J Cancer. 2000 Nov;36(17):2221-6. doi: 10.1016/s0959-8049(00)00313-0.
Cervical cancer is one of the target cancers covered by the statutory German cancer screening programme which was introduced in West Germany in 1971 and expanded to the eastern part of the country in 1991. Women covered by statutory health insurance (over 90% of the female population) are eligible to receive an annual cervical examination including a Papanicolaou (PAP) smear beginning at age 20 years. Annual uptake currently slightly exceeds 50% of the eligible population. Shortly after implementation of the national screening programme in the early 1970s the incidence of invasive cervical cancer decreased moderately and the incidence of cervical carcinoma in situ increased substantially in the state of Saarland. These observations would be expected as a result of a cervical cancer screening programme with substantial uptake. Although quality assurance guidelines for cervical cancer screening have been adopted and updated since the inception of the screening programme, only minor changes have been made in the cross-sectional programme documentation. Implementation of population-based documentation and evaluation of screening activities is currently being developed for the German cancer screening programme in pilot studies implementing the European guidelines on the quality assurance of mammography screening. After demonstration of feasibility and effectiveness, improvements in the quality management of breast cancer screening will subsequently be applied to the cervical cancer screening programme.
宫颈癌是德国法定癌症筛查项目涵盖的目标癌症之一。该项目于1971年在西德推行，1991年扩展至德国东部。参加法定医疗保险的女性（占女性人口的90%以上）从20岁起有资格接受年度宫颈检查，包括巴氏涂片检查。目前，年度检查参与率略高于 eligible population的50%。20世纪70年代初国家筛查项目实施后不久，萨尔兰州浸润性宫颈癌的发病率略有下降，原位宫颈癌的发病率大幅上升。这些观察结果是宫颈癌筛查项目大量参与的预期结果。尽管自筛查项目启动以来已采用并更新了宫颈癌筛查的质量保证指南，但在横断面项目文档中仅做了微小改动。目前，德国癌症筛查项目正在开展试点研究，以实施基于人群的文档记录和筛查活动评估，这些试点研究采用了欧洲乳腺钼靶筛查质量保证指南。在证明可行性和有效性后，乳腺癌筛查质量管理的改进措施随后将应用于宫颈癌筛查项目。
