Casa de Oswaldo Cruz, Fiocruz, Brazil.
Soc Stud Sci. 2011 Aug;41(4):585-608. doi: 10.1177/0306312711408380.
The quasi-totality of social scientists who studied screening for cervical tumours identified such screening with a single method: the Pap smear (exfoliative cytology). This article explains that this method was not valid everywhere. The history of screening for cervical cancer in Brazil displays an alternative method for detecting cervical malignancies: a direct observation of the cervix with a specific instrument--the colposcope. The development of this method in Brazil in the 1940s and 1950s reflected a complex mixture of professional interests, government policies, and regional, local and charitable initiatives. While the use of colposcopy for cervical tumour screening was phased out in the 1970s and 1980s, the long lifespan and widespread diffusion of this method illuminates the irreducible contingency of specific developments in science, technology and medicine. Seen from the vantage point of Brazil, the Western model for preventing cervical malignancies no longer appears self-evident Alternative choices might have led to the development of different material and visual cultures of medicine, stimulated different patterns of medical specialization and division of medical labour, produced different links between malignancies, women, gynaecologists, epidemiologists and public health experts, and shaped different health policies.
巴氏涂片（脱落细胞学）。本文指出，这种方法并非在所有地方都有效。巴西的宫颈癌筛查史展示了另一种检测宫颈癌的方法：使用一种特殊仪器——阴道镜，直接观察宫颈。20 世纪 40 年代至 50 年代，该方法在巴西的发展反映了专业利益、政府政策以及地区、地方和慈善倡议的复杂混合。虽然阴道镜在宫颈癌筛查中的应用在 20 世纪 70 年代和 80 年代逐渐淘汰，但该方法的长期存在和广泛传播揭示了科学、技术和医学特定发展的不可避免的偶然性。从巴西的角度来看，预防宫颈癌的西方模式不再显得不言而喻。替代选择可能导致医学的不同物质和视觉文化的发展，刺激不同模式的医学专业化和医学劳动分工，在恶性肿瘤、妇女、妇科医生、流行病学家和公共卫生专家之间产生不同的联系，并塑造不同的卫生政策。
