Salmerón-Castro J, Kazcano Ponce E C, Pérez Cuevas R, del Río Gómez I, Torres Torija I, Hernández Avila M
Unidad de Investigación Epidemiológica y en Servicios de Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Avenida Cuahutemoc 330, Unidad de Congresos, Bloque B, 4o piso, México, D. F., C. P. 06720, México.
Cad Saude Publica. 1998;14 Suppl 3:67-75. doi: 10.1590/s0102-311x1998000700007.
The uterine cervix is the most common cancer site for females. Approximately 52,000 new cases occur annually in Latin America, thus the need to improve efficiency and effectiveness of Cervical Cancer Screening Programs (CCSP) is mandatory to decrease the unnecessary suffering women must bear. This paper is addressing essential issues to revamp the CCSP as proposed by the Mexican official norm. A general framework for institutionalizing CCSP is outlined. Furthermore, strategies to strengthen CCSP performance through managerial strategies and quality assurance activities are described. The focus is on the following activities: 1) improving coverage; 2) implementing smear-taking quality control; 3) improving quality in interpretation of Pap test; 4) guaranteeing treatment for women for whom abnormalities are detected; 5) improving follow-up; 6) development of quality control measures and 7) development of monitoring and epidemiological surveillance information systems. Changes within the screening on cervical cancer may be advocated as new technologies present themselves and shortcomings in the existing program appear. It is crucial that these changes should be measured through careful evaluation in order to tally up potential benefits.
子宫颈是女性最常见的癌症发病部位。在拉丁美洲，每年约有52000例新发病例，因此提高宫颈癌筛查项目（CCSP）的效率和效果对于减少女性不必要承受的痛苦而言是必不可少的。本文探讨了按照墨西哥官方规范对CCSP进行改进的关键问题。概述了将CCSP制度化的总体框架。此外，还描述了通过管理策略和质量保证活动来加强CCSP绩效的策略。重点在于以下活动：1）提高覆盖率；2）实施涂片采集质量控制；3）提高巴氏试验解读质量；4）确保对检测出异常的女性进行治疗；5）改进随访；6）制定质量控制措施；7）开发监测和流行病学监测信息系统。随着新技术的出现以及现有项目缺陷的显现，宫颈癌筛查方面的变革可能会被提倡。至关重要的是，这些变革应通过仔细评估来衡量，以便总结潜在益处。
