Bagnall Helen, Pearmain Philippa, Clare Joanne, Lawrence Gill
Cervical Screening QA Reference Centre, West Midlands Cancer Intelligence Unit, The University of Birmingham, Birmingham, UK.
J Med Screen. 2006;13(3):137-47. doi: 10.1258/096914106778440590.
To examine the ability of existing classification systems to provide screening histories for invasive cervical cancers which can be used in the evaluation of the NHS Cervical Screening Programme (NHSCSP), and to provide the diagnostic route data item required for the National Cancer Data Set (NCDS).
The ability of existing classification systems to derive unique, consistent screening histories for a cohort of invasive cervical cancers diagnosed in the West Midlands region in the period 2000-03 was tested using two separate timelines for women on normal routine recall (usually 3 or 5 years) and those on early recall having had an inadequate, low-grade abnormal or negative smear.
Neither of the existing classification systems was capable of adequately categorizing all invasive cervical cancers. An original classification system incorporating features from the existing systems was therefore developed. This system includes both a 'screening status' component that essentially describes the status of a woman's interaction with the NHSCSP at the time her cancer was diagnosed, and a 'screening history' component that describes the results of previous screening tests.
National adoption of this new screening histories classification system would provide a detailed, consistent, nationally comparable screening history for all invasive cervical cancers which can be used in the national and regional evaluation of the NHSCSP and in local audit by clinical teams supplemented by histology and colposcopy data. The classification categories could be collapsed down to provide the diagnostic route data item required for the NCDS.
研究现有分类系统为浸润性宫颈癌提供筛查史的能力，以便用于评估英国国家医疗服务体系宫颈癌筛查计划（NHSCSP），并提供国家癌症数据集（NCDS）所需的诊断途径数据项。
利用两条独立的时间线，对2000 - 2003年在西米德兰兹地区诊断出的一组浸润性宫颈癌患者进行测试，一条时间线针对正常常规召回的女性（通常为3年或5年），另一条针对因涂片检查不充分、低级别异常或阴性而提前召回的女性，以此检验现有分类系统为这些患者得出独特、一致的筛查史的能力。
现有的分类系统均无法对所有浸润性宫颈癌进行充分分类。因此，开发了一种结合现有系统特征的原始分类系统。该系统包括一个“筛查状态”部分，主要描述女性在癌症确诊时与NHSCSP的互动状态，以及一个“筛查史”部分，描述先前筛查测试的结果。
在全国采用这种新的筛查史分类系统，将为所有浸润性宫颈癌提供详细、一致且全国可比的筛查史，可用于NHSCSP的国家和地区评估以及临床团队在组织学和阴道镜检查数据辅助下的局部审计。分类类别可以合并以提供NCDS所需的诊断途径数据项。
