Wain G V, Farnsworth A, Hacker N F
Royal Hospital for Women, Paddington, NSW.
Med J Aust. 1992 Jul 6;157(1):14-6. doi: 10.5694/j.1326-5377.1992.tb121599.x.
This study looks at the Papanicolaou (Pap) smear histories of patients presenting with invasive cervical cancer, to assess the problems associated with the cervical cancer screening program within New South Wales.
Prospective collection of data concerning the Pap smear history, age, menopausal status and stage of disease of patients presenting with invasive cervical cancer.
All patients with primary invasive cervical cancer referred to the Gynaecological Oncology Department of the Royal Hospital for Women, Paddington, between November 1986 and July 1990 were included in the analysis.
Eighty-three out of 237 patients (35%) reported never having had a Pap smear taken. These patients were on average older, more frequently postmenopausal and presented with more advanced stage of disease than the rest of the population. Fifty-one patients (21.5%) stated that they had had a "normal" smear within two years. Further analysis revealed that mistaken patient recall of the date of the last Pap smear and false-negative cytological reporting were the major factors explaining these latter cases.
For voluntary screening to be more effective, quality control of cytology laboratories needs to be carefully evaluated and general practitioners need to take a more active role in cancer screening. In order to reach a greater proportion of the population, a national or State cytology register should be established.
本研究观察了浸润性宫颈癌患者的巴氏涂片检查史，以评估新南威尔士州宫颈癌筛查项目存在的问题。
前瞻性收集浸润性宫颈癌患者的巴氏涂片检查史、年龄、绝经状态及疾病分期等数据。
分析1986年11月至1990年7月间转诊至帕丁顿皇家妇女医院妇科肿瘤科的所有原发性浸润性宫颈癌患者。
237例患者中有83例（35%）报告从未进行过巴氏涂片检查。这些患者平均年龄更大，绝经后女性更为常见，且疾病分期比其他患者更晚。51例患者（21.5%）称在两年内曾有过“正常”涂片检查结果。进一步分析显示，患者对末次巴氏涂片检查日期的错误回忆以及细胞学检查报告的假阴性是导致后一种情况的主要因素。
为提高自愿筛查的效果，需要仔细评估细胞学实验室的质量控制，全科医生需要在癌症筛查中发挥更积极的作用。为了覆盖更多人群，应建立全国或州级细胞学登记系统。
