Weisman C S, Celentano D D, Hill M N, Teitelbaum M A
Prev Med. 1986 Jul;15(4):342-51. doi: 10.1016/0091-7435(86)90002-2.
Since 1976, contradictory recommendations by a number of groups (including the American Cancer Society, the National Cancer Institute, a National Institutes of Health Consensus Development Conference, the Canadian Task Force on Cervical Cancer Screening Programs, and the American College of Obstetricians and Gynecologists) on the timing of Pap testing--including age to begin testing, appropriate frequency of testing, and age to discontinue testing--have been communicated to both physicians and consumers. The opinions and practices of a U.S. national sample of recently trained obstetrician-gynecologists, whose professional association continues to endorse annual Pap tests, were investigated and compared with key points from the various recommendations. The appropriateness of the recommendations themselves is not addressed. Findings show that respondents are aware of recommendations for less frequent Pap testing, but they believe that women should generally receive annual Pap tests and that regular Pap testing should not be discontinued among the elderly. While the intensity of Pap testing services varies by type of practice arrangement, such variation does not occur for opinions regarding Pap testing, with one exception: Those practicing in multispecialty groups (including health maintenance organizations) are more likely to endorse routine Pap testing for elderly women if they see elderly women in their practices. Thus, the physicians in this study are not adhering to recommendations for Pap testing on a less-than-annual basis or for discontinuance in the elderly.
自1976年以来,多个组织(包括美国癌症协会、美国国立癌症研究所、美国国立卫生研究院共识发展会议、加拿大宫颈癌筛查项目特别工作组以及美国妇产科医师学会)就巴氏试验的时间安排——包括开始检测的年龄、适当的检测频率以及停止检测的年龄——给出了相互矛盾的建议,并传达给了医生和普通民众。对美国近期接受培训的妇产科医生全国样本的观点和做法进行了调查,这些医生的专业协会仍支持每年进行巴氏试验,并将其与各项建议的要点进行了比较。本文未探讨这些建议本身是否恰当。研究结果显示,受访者知晓减少巴氏试验频率的建议,但他们认为女性一般应每年接受巴氏试验,而且老年人不应停止定期巴氏试验。虽然巴氏试验服务的强度因执业安排类型而异,但在巴氏试验观点方面不存在这种差异,只有一个例外:在多专科团体(包括健康维护组织)执业的医生,如果在其诊疗过程中接待老年女性,那么他们更有可能支持为老年女性进行常规巴氏试验。因此,本研究中的医生并未遵循关于减少巴氏试验频率或在老年人中停止试验的建议。