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[2006年匈牙利有组织的宫颈癌筛查项目状况]

[The state of organized cervical screening program in Hungary in 2006].

作者信息

Kovacs Attila, Dobrossy Lajos, Budai Andras, Boncz Imre, Cornides Agnes

机构信息

Országos Tisztifôorvosi Hivatal, Budapest, Hungary.

出版信息

Orv Hetil. 2007 Mar 25;148(12):535-40. doi: 10.1556/OH.2007.28075.

Abstract

Theoretically, there is a real prospect for full eradication of cervical cancer by cytology screening. In several countries the burden of cervical cancer significantly decreased due to regular screening of the population. In Hungary, the complex "gynecological screening", including colposcopic examination, has a long tradition, however, the efforts of several decades are not reflected in the mortality: about 500 women are killed by cervical cancer each year. The screening protocol represents a compromise between the traditional "gynecological screening" and the internationally recommended organized screening: taking sample for cytology is an essential element of the gynecological examination. The National Public Health Programme has established the technical and organizational preconditions of an organized screening programme. The early experiences with the "call-and-recall" organized screening -- started at the end of 2003 -- are unfavourable, because the compliance rates are unacceptably low. The majority of the women receive screening in a traditional way, i.e. outside the programme; another proportion of them simply ignores the invitation, and does not accept the offered screening. To improve the current situation, following the recommendation of "the-state-of-the-art", an attempt is made to intensify the involvement of the primary care personnel. There is a need to revise the current financing system by the political decision-makers in the health field. The access to the screening facilities needs to be improved, the attitude of the medical community changed, and the efficiency of the communication with the public significantly improved.

摘要

从理论上讲,通过细胞学筛查完全根除宫颈癌具有现实前景。在一些国家,由于对人群进行定期筛查,宫颈癌负担显著降低。在匈牙利,包括阴道镜检查在内的综合“妇科筛查”有着悠久传统,然而,几十年的努力并未在死亡率上得到体现:每年约有500名女性死于宫颈癌。筛查方案是传统“妇科筛查”与国际推荐的有组织筛查之间的一种折衷:采集细胞学样本是妇科检查的一个基本要素。国家公共卫生计划已经建立了有组织筛查计划的技术和组织前提条件。2003年底开始的“召回式”有组织筛查的早期经验并不理想,因为依从率低得令人无法接受。大多数女性以传统方式接受筛查,即在该计划之外;其中另一部分女性干脆无视邀请,不接受提供的筛查。为改善当前状况,按照“最新技术水平”的建议,试图加强基层医疗人员的参与。卫生领域的政治决策者需要修订现行融资体系。需要改善筛查设施的可及性,改变医学界的态度,并大幅提高与公众沟通的效率。

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