Lai M Y, Chou P
Institute of Public Health, National Yang-Ming Medical College.
Zhonghua Yi Xue Za Zhi (Taipei). 1992 Feb;49(2):81-5.
The cervical cancer screening program in Taiwan was carried out in two phases. This study was based on the Phase II data from April 1, 1979, through June 30, 1984. There were 56 completed data cases of invasive cervical cancer. The purposes of this case-control study was: (1) to estimate an exposure odds ratio; (2) to estimate the prevented fraction (PF), proportion of potential cases that were actually prevented by the Pap smear test in the screened population; and (3) to study factors related to the effectiveness of screening. The protective effect of a previous Pap test was not shown between cases and controls in this study. The PFs were 6% for the screened population and 20% for those having had a previous Pap test. No significant protected effect of a previous Pap test was found in this study, whether in univariate analysis or logistic regression. Possible explanations are: (1) incomplete follow-up for those women with abnormal smears; (2) high false negative rate due to laboratory error, or poor technique in smear taking; (3) infrequent screening with too long a screening interval; (4) low coverage rate of a Pap test; and (5) selection bias.
台湾的子宫颈癌筛查计划分两个阶段实施。本研究基于1979年4月1日至1984年6月30日的第二阶段数据。有56例浸润性子宫颈癌的完整数据病例。这项病例对照研究的目的是:(1)估计暴露比值比;(2)估计预防分数(PF),即在筛查人群中通过巴氏涂片检查实际预防的潜在病例比例;(3)研究与筛查效果相关的因素。在本研究中,病例组和对照组之间未显示先前巴氏试验的保护作用。筛查人群的PF为6%,曾接受过巴氏试验的人群为20%。在本研究中,无论是单变量分析还是逻辑回归,均未发现先前巴氏试验有显著的保护作用。可能的解释是:(1)涂片异常的女性随访不完整;(2)由于实验室误差或涂片采集技术不佳导致假阴性率高;(3)筛查频率低且筛查间隔时间过长;(4)巴氏试验覆盖率低;(5)选择偏倚。