Jones M H, Singer A, Jenkins D
Department of Colposcopy, Whittington Hospital, London, England.
J R Soc Med. 1996 May;89(5):257-60.
Argument continues over the best management of women with a first mildly dyskaryotic cervical smear: should they be referred for prompt colposcopy, or should they be kept under cytological review, with recourse to colposcopy if the abnormality persists? One consideration is the amount of anxiety generated. We measured anxiety, retrospectively, in two groups of women who had been managed by one or other method. Colposcopy caused more anxiety than cytological surveillance. When told that their smear was mildly abnormal, 47% of the immediate-colposcopy group (n = 182), compared with 33% of the surveillance group (n = 163), thought they had cancer. None the less, there was a general preference for immediate colposcopy. Whatever the relative merits of these two strategies for clinical management, it is clear that both forms of screening, and especially colposcopy, demand better information for patients.
对于首次宫颈涂片轻度核异质的女性，最佳管理方式仍存在争议：是应立即转诊进行阴道镜检查，还是应进行细胞学复查，若异常持续则再进行阴道镜检查？一个需要考虑的因素是引发的焦虑程度。我们回顾性地测量了两组分别采用上述不同方法管理的女性的焦虑程度。阴道镜检查比细胞学监测引发的焦虑更多。当被告知她们的涂片有轻度异常时，立即进行阴道镜检查组（n = 182）中有47%的女性认为自己患了癌症，而监测组（n = 163）中这一比例为33%。尽管如此，总体上人们还是更倾向于立即进行阴道镜检查。无论这两种临床管理策略的相对优点如何，很明显这两种筛查形式，尤其是阴道镜检查，都需要为患者提供更好的信息。
