Can Med Assoc J. 1982 Oct 1;127(7):581-9.
The Canadian Task Force on Cervical Cancer Screening Programs, which produced its first report in 1976, was reconvened by the Department of National Health and Welfare in 1980 in response to concerns expressed about the significance of new data, changing sociosexual patterns and wide variations in the implementation of the 1976 recommendations. This article is a summary of the 1982 task force report. In addition to updates of the 1976 material new sections appear on groups at risk, mathematical models of screening, quality control in screening programs, cytologic screening coverage of the Canadian population and management of patients with abnormal smears. The 1982 recommendations deal with frequency of screening, laboratory quality control and follow-up mechanisms. The task force concludes that measures to improve the quality and sensitivity of screening programs and to include women who have never been screened will be more effective in reducing mortality from carcinoma of the cervix than will attempts to increase the frequency of screening. The task force views as unnecessary the annual screening of women over 35 years of age whose previous smears have been normal. Since younger women are sexually more active and tend to have more than one sexual partner they are at high risk. Therefore, the task force recommends annual screening for sexually active women aged 18 to 35 years. Physicians, health care professionals and government health agencies have a role to play in informing women about the recommended intervals for cervical smears and ensuring that screening programs of adequate quality are available. Although women are primarily responsible for entering and continuing in such a program, government-sponsored registries are essential if the full potential of cervical smear programs is to be realized.
加拿大宫颈癌筛查项目特别工作组于1976年发布了首份报告。1980年,鉴于人们对新数据的重要性、社会性行为模式的变化以及1976年建议实施情况的巨大差异表示担忧,国家卫生和福利部重新召集了该工作组。本文是1982年特别工作组报告的摘要。除了更新1976年的资料外,新章节还涉及高危人群、筛查的数学模型、筛查项目中的质量控制、加拿大人群的细胞学筛查覆盖率以及异常涂片患者的管理。1982年的建议涉及筛查频率、实验室质量控制和后续机制。特别工作组得出结论,提高筛查项目的质量和敏感性以及将从未接受过筛查的女性纳入其中的措施,在降低宫颈癌死亡率方面将比增加筛查频率的尝试更有效。特别工作组认为,对于之前涂片正常的35岁以上女性进行年度筛查没有必要。由于年轻女性性行为更活跃,往往有多个性伴侣,她们处于高风险状态。因此,特别工作组建议对18至35岁的性活跃女性进行年度筛查。医生、医疗保健专业人员和政府卫生机构在告知女性宫颈涂片推荐间隔并确保提供质量足够的筛查项目方面发挥着作用。尽管女性主要负责参与并持续参与此类项目,但如果要充分发挥宫颈涂片项目的潜力,政府资助的登记系统至关重要。