Zuna R E
Postgrad Med. 1984 Nov 1;76(6):36-40, 42-3, 46. doi: 10.1080/00325481.1984.11698775.
Despite the widespread acceptance of the Pap smear as an effective means to reduce morbidity and mortality due to cervical carcinoma, many experts now recommend less frequent screening for women with a negative cytologic history and factors carrying a low degree of risk. This view has been countered by those who feel that less frequent screening may result in a dangerous delay in diagnosis and treatment for some women. The trend toward a longer screening interval places a burden on the primary care physician, the pathologist, and cytotechnologists to minimize false-negative smears through optimum communication, technical preparation, and quality control. In addition to the changes in thinking regarding frequency of Pap smear screening, the concept of cervical carcinogenesis is undergoing striking modification. The human papillomavirus has been associated with many lesions that have classically been considered low-grade dysplasias. Termed flat condylomas, these lesions frequently regress spontaneously but may be associated with the full spectrum of preinvasive and invasive disease. Cervical condylomas require biopsy and appropriate treatment.
尽管巴氏涂片作为降低宫颈癌发病率和死亡率的有效手段已被广泛接受，但现在许多专家建议，对于细胞学检查历史为阴性且风险程度较低的女性，筛查频率可以降低。这一观点遭到了一些人的反对，他们认为筛查频率降低可能会导致一些女性在诊断和治疗上出现危险的延误。延长筛查间隔的趋势给初级保健医生、病理学家和细胞技术人员带来了负担，他们需要通过最佳的沟通、技术准备和质量控制来尽量减少假阴性涂片。除了在巴氏涂片筛查频率方面的观念变化外，宫颈癌发生的概念也正在经历显著的改变。人乳头瘤病毒与许多传统上被认为是低级别发育异常的病变有关。这些病变被称为扁平湿疣，它们经常会自发消退，但可能与一系列的癌前病变和浸润性疾病有关。宫颈湿疣需要进行活检和适当的治疗。
