Saint Mona, Gildengorin Ginny, Sawaya George F
Department of Obstetrics and Gynecology, Kaiser Permanente Northern California, USA.
Am J Obstet Gynecol. 2005 Feb;192(2):414-21. doi: 10.1016/j.ajog.2004.09.026.
The purpose of this study was to determine cervical cancer screening practices of obstetrician/gynecologists in the US after recent revised guidelines.
Questionnaires were mailed to 355 randomly selected US obstetrician/gynecologists. Questions were structured as clinical vignettes.
Questionnaires were returned by 60% (213/355) of recipients; 185 were eligible. Seventy-four percent would begin screening virginal girls at age 18. Sixty percent would continue annual screening in a 35-year-old woman with 3 or more normal tests. Frequent screening is common in women after total hysterectomy for symptomatic fibroids and no history of dysplasia, and in 70-year-old women with a 30-year history of previous normal tests. Most (82%) use liquid-based cytology; 78% of female respondents would prefer it for themselves. Most (64%) would not adopt triennial Pap/HPV DNA screening, although 58% of women would choose it for themselves.
Most US obstetrician/gynecologists screen low-risk women often and indefinitely, despite national guidelines designed to minimize screening harms resulting from overtesting.
本研究旨在确定近期修订指南后美国妇产科医生的宫颈癌筛查实践情况。
向355名随机选取的美国妇产科医生邮寄调查问卷。问题以临床病例 vignettes 的形式构建。
60%(213/355)的收件人回复了问卷;185份问卷符合要求。74%的医生会在18岁开始对处女进行筛查。60%的医生会对连续3次或更多次检查结果正常的35岁女性继续进行年度筛查。对于因有症状的子宫肌瘤而进行全子宫切除且无发育异常病史的女性以及有30年既往检查结果均正常病史的70岁女性,频繁筛查较为常见。大多数(82%)使用液基细胞学检查;78%的女性受访者自己会倾向于选择这种检查方法。大多数(64%)医生不会采用每三年一次的巴氏涂片/人乳头瘤病毒(HPV)DNA联合筛查,尽管58%的女性自己会选择这种筛查方式。
尽管国家指南旨在尽量减少过度检查导致的筛查危害,但大多数美国妇产科医生经常且无限制地对低风险女性进行筛查。