Eardley A, Elkind A K, Spencer B, Hobbs P, Pendleton L L, Haran D
Soc Sci Med. 1985;20(9):955-62. doi: 10.1016/0277-9536(85)90352-1.
Despite the existence of an effective screening technique for cancer of the cervix, incidence and mortality from this disease have not declined in the United Kingdom. The basic problem is that women most at risk of the disease are under-represented in the screened population. The evidence for two different points of view to explain this situation is examined. These viewpoints are the failure of the women to attend, and the failure of the service to meet the needs of women. This paper argues that the evidence supports the view that the organisation of the existing screening service impedes the maximum participation of at-risk women. We discuss the features that an effective service needs to incorporate, and put forward principles for the development of a more effective screening system, namely, that it should be provider-initiated and user-oriented.
尽管存在一种有效的宫颈癌筛查技术，但在英国，这种疾病的发病率和死亡率并未下降。根本问题在于，在接受筛查的人群中，最易患该病的女性所占比例过低。本文审视了用以解释这种情况的两种不同观点的证据。这两种观点分别是女性未能前来就诊，以及筛查服务未能满足女性的需求。本文认为，证据支持这样一种观点，即现有筛查服务的组织方式阻碍了高危女性的最大程度参与。我们讨论了有效服务需要具备的特征，并提出了发展更有效筛查系统的原则，即该系统应由提供者发起并以用户为导向。
