Shen R N, Hicks D A, Cruickshank M E
Department of Genito-Urinary Medicine, Royal Hallamshire Hospital, Sheffield, UK.
Int J STD AIDS. 1996 Mar-Apr;7(2):98-101. doi: 10.1258/0956462961917456.
Postal questionnaires were circulated to all Genito-Urinary Medicine (GUM) clinics in the UK (in parallel with questionnaires circulated to gynaecologists) on behalf of British Society for Colposcopy and Cervical Pathology (BSCCP) and National Co-ordinating Network (NCN) to audit colposcopy services. Information was sought on colposcopy workload, referral criteria, treatment method and followup, waiting times, staffing and training. A similar but less comprehensive survey of colposcopy services in GUM was undertaken in 1990 enabling direct comparison of some but not all aspects of the service in the last 3 to 4 years. One hundred and forty-two GUM Clinics replied. Of those who replied, 70 (49.3%) clinics provided a colposcopy service; an increase from 60 to 70 clinics since 1990. However, only 66 clinics provided detailed information for analysis. Forty-six out of 66 (69.7%) clinics performed treatment for some or all of their patients and the most frequent methods of treatment used were loop excision and cold coagulation. One hundred and seventy-two (range 8-1982) patients were seen per annum with a mean of 7 (range 1-68) colposcopy sessions per month. Sixty-four per cent of these sessions were undertaken by consultants, 14% by training grades and the rest by Clinical Assistants and Associate Specialists. Fifty-three per cent of all patients with abnormal smears were colposcoped within 2 weeks and the maximum waiting period was less than 8 weeks for all severe dyskaryosis/malignant cells cytology reports; 1.6% of clinics admitted to having cases of invasive cervical cancer following previous treatment of cervical intraepithelial neoplasia (CIN) and 96% of clinics had a protocol in place for defaulters. The default rate was 12% both for new and follow-up patients. Thirty out of 70 (43%) clinics were computerized and 50/66 (75.8%) of clinics collected accurate statistics.
代表英国阴道镜检查与宫颈病理学会（BSCCP）和国家协调网络（NCN），向英国所有泌尿生殖医学（GUM）诊所发放了邮政调查问卷（同时也向妇科医生发放了调查问卷），以审核阴道镜检查服务情况。调查内容包括阴道镜检查工作量、转诊标准、治疗方法及随访、等待时间、人员配备和培训情况。1990年曾对GUM诊所的阴道镜检查服务进行过一次类似但不太全面的调查，从而能够对过去三到四年里该服务的部分（而非全部）方面进行直接比较。142家GUM诊所进行了回复。在回复的诊所中，70家（49.3%）提供阴道镜检查服务，自1990年以来从60家增加到了70家。然而，只有66家诊所提供了详细信息用于分析。66家诊所中有46家（69.7%）为部分或全部患者进行治疗，最常用的治疗方法是环形切除术和冷凝法。每年接待172名（范围为8 - 1982名）患者，每月平均进行7次（范围为1 - 68次）阴道镜检查。这些检查中64%由顾问医生进行，14%由实习医生进行，其余由临床助理和副专科医生进行。所有涂片异常的患者中有53%在两周内接受了阴道镜检查，对于所有重度核异质/恶性细胞细胞学报告，最长等待期不到8周；1.6%的诊所承认在先前治疗宫颈上皮内瘤变（CIN）后出现浸润性宫颈癌病例，96%的诊所制定了针对失访者的方案。新患者和随访患者的失访率均为12%。70家诊所中有30家（43%）实现了计算机化，66家诊所中有50家（75.8%）收集了准确的统计数据。
