Havelock C M, Webb J, Queenborough J
Wexham Park Hospital, Slough, Berkshire.
BMJ. 1988 Nov 26;297(6660):1384-6. doi: 10.1136/bmj.297.6660.1384.
A recognised problem with the cervical screening programme in the United Kingdom is the failure to include women who have never had a cervical smear test, who are a high risk group. The implementation of a district based call scheme in East Berkshire in 1986 is described whereby women aged 20-64 with no record of a cervical smear test who were judged to be eligible for testing by their general practitioner were sent a personal invitation from their general practitioner to attend for a test. A list of high risk unscreened women was kept by each practice, and a duplicate sent to the cytology laboratory to update the central records. Six months after each batch of invitations had been sent the resulting number of women having a smear test was assessed. Forty three of 51 practices approached agreed to participate in the five year scheme. During the first year lists were sent to the 43 participating practices. The first list was returned to the cytology laboratory by 37 practices and the second by 33; practices varied in their responses, however, some needing considerable persuasion to return the lists. Of 972 identified unscreened women from the total 3757 women listed in the lists of the family practitioner committee, 247 (25%) had a cervical smear test in response to the invitation, representing an overall increase of 7% in the screened population. The preliminary findings of the five year study have shown that screening can be improved by a systematic call scheme. Coordinated support from the area health authority in health education, monitoring of screening, and feedback of data from the scheme to practices is required to reduce the proportion of unscreened women.
英国宫颈筛查计划中一个公认的问题是未能将从未进行过宫颈涂片检查的女性纳入其中，而这部分女性属于高危群体。本文描述了1986年在东伯克郡实施的一项基于地区的电话通知计划，即向年龄在20至64岁之间、无宫颈涂片检查记录且经全科医生判断符合检查条件的女性发出全科医生的个人邀请，邀请她们前来接受检查。每家诊所都保留了一份高危未筛查女性名单，并将副本送交细胞学实验室以更新中央记录。在每批邀请发出六个月后，对接受涂片检查的女性人数进行评估。联系的51家诊所中有43家同意参与这项为期五年的计划。在第一年，名单被发送到43家参与计划的诊所。37家诊所将第一份名单返回给了细胞学实验室，33家返回了第二份名单；然而，各诊所的回应情况各不相同，有些诊所需要经过大量劝说才返回名单。在家庭医生委员会名单上列出的3757名女性中，经确认有972名未筛查女性，其中247名（25%）响应邀请进行了宫颈涂片检查，这使得筛查人群总体增加了7%。这项为期五年研究的初步结果表明，通过系统的电话通知计划可以改善筛查情况。需要地区卫生当局在健康教育、筛查监测以及将该计划的数据反馈给诊所方面提供协调支持，以减少未筛查女性的比例。
