Suba Eric J, Murphy Sean K, Donnelly Amber D, Furia Lisa M, Huynh My Linh D, Raab Stephen S
Department of Pathology, Kaiser Permanente Medical Center, 1200 El Camino Real, South San Francisco, CA 94080, USA.
Am J Public Health. 2006 Mar;96(3):480-7. doi: 10.2105/AJPH.2004.061606. Epub 2006 Jan 31.
Papanicolaou screening is feasible anywhere that screening for cervical cancer, the leading cause of cancer-related death among women in developing countries, is appropriate. After documenting that the Vietnam War had contributed to the problem of cervical cancer in Vietnam, we participated in a grass roots effort to establish a nationwide cervical cancer prevention program in that country and performed root cause analyses of program deficiencies. We found that real-world obstacles to successful cervical cancer prevention in developing countries involve people far more than technology and that such obstacles can be appropriately managed through a systems approach focused on programmatic quality rather than through ideological commitments to technology. A focus on quality satisfies public health goals, whereas a focus on technology is compatible with market forces.
巴氏涂片筛查在任何适合开展宫颈癌筛查的地方都是可行的，宫颈癌是发展中国家女性癌症相关死亡的主要原因。在记录了越南战争导致越南宫颈癌问题后，我们参与了一项基层工作，在该国建立了一个全国性的宫颈癌预防项目，并对项目缺陷进行了根本原因分析。我们发现，发展中国家成功预防宫颈癌的现实障碍涉及的人群因素远远超过技术因素，而且通过注重项目质量的系统方法，而非对技术的意识形态承诺，能够恰当地应对这些障碍。关注质量符合公共卫生目标，而关注技术则与市场力量相契合。
