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美国癌症中心的公共宫颈癌筛查建议:评估对国家指南的遵循情况。

Public cervical cancer screening recommendations from US cancer centers: Assessing adherence to national guidelines.

机构信息

Department of Surgery, New York Presbyterian/Weill Cornell Medical Center, New York, NY, USA.

Department of Population Health Sciences, Weill Cornell Medical Center, New York, NY, USA.

出版信息

J Med Screen. 2024 Sep;31(3):201-204. doi: 10.1177/09691413241238960. Epub 2024 Mar 20.

Abstract

Though widespread adoption of cervical cancer screening (CCS) in the US has been associated with a reduction in cervical cancer incidence and mortality, screening also carries with it potential risks. Newer national guidelines recommend decreased screening frequency to optimize the benefit/risk balance and to prevent over-screening. Here, we examined the alignment of US cancer center websites' public recommendations on CCS with national guidelines. We reviewed the websites of 1024 cancer centers accredited by the US Commission on Cancer during January-August 2022. We recorded the recommended frequency and type of CCS and any screening risks mentioned, comparing against national US Preventive Service Task Force (USPSTF) and American Cancer Society (ACS) guidelines. Of 1024 US cancer centers, 60% (610) provided CCS recommendations. Most centers are in alignment with the screening starting age (96%, 544/565) and stopping age (94%, 440/470) recommended by national guidelines. Of 508 centers specifying the frequency of standalone cervical cytology, 83% (419) recommended a screening interval of three years; however, 14% (73) recommended cervical cytology more frequently than the three-year interval recommended by the ACS/USPSTF. Screening risks were mentioned by 20% (124/610) of centers. Our findings highlight the importance of education on screening benefits and risks for physicians and patients to enable shared decision making based on evidence-based guidelines.

摘要

尽管美国广泛采用宫颈癌筛查(CCS)与宫颈癌发病率和死亡率的降低相关,但筛查也存在潜在风险。新的国家指南建议降低筛查频率,以优化效益/风险平衡,并防止过度筛查。在这里,我们研究了美国癌症中心网站上关于 CCS 的公共建议与国家指南的一致性。我们在 2022 年 1 月至 8 月期间审查了美国癌症委员会认证的 1024 家癌症中心的网站。我们记录了推荐的 CCS 频率和类型,以及提到的任何筛查风险,并与美国预防服务工作组(USPSTF)和美国癌症协会(ACS)的国家指南进行了比较。在 1024 家美国癌症中心中,有 60%(610 家)提供了 CCS 建议。大多数中心与国家指南推荐的筛查起始年龄(96%,544/565)和停止年龄(94%,440/470)一致。在 508 家指定单独宫颈细胞学筛查频率的中心中,83%(419 家)建议筛查间隔为三年;然而,14%(73 家)建议的宫颈细胞学检查频率高于 ACS/USPSTF 推荐的三年间隔。有 20%(124/610)的中心提到了筛查风险。我们的研究结果强调了为医生和患者提供关于筛查益处和风险的教育的重要性,以便根据循证指南进行共同决策。

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