与指导方针一致和过度宫癌查相关的因素:一种混合方法研究
Rebecca B Perkins1, Lindsay Fuzzell2, Paige Lake2
1Boston University, Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, Massachusetts.
概括
大多数临床医生使用联合测试进行宫癌查,但遵守5年间隔的情况各不相同. 了解指南证据和改进风险评估是适当查和减少过度查的关键.
科学领域:
- 妇科 妇科医生 妇科
- 预防医学 预防医学
- 公共卫生 公共卫生
背景情况:
- 国家指导方针建议,对于30-65岁的平均风险人群,每3-5年进行一次宫癌查.
- 建议每3年进行一次巴氏球菌 (Pap) 检测,同时每5年进行一次人类乳头瘤病毒 (HPV) 单独检测或与巴氏球菌联合检测.
研究的目的:
- 探索与临床医生报告的指导方针一致的宫癌查相关的因素.
- 确定适当的宫癌查实践的促进者和障碍者.
主要方法:
- 一项针对1,251名临床医生的全国性调查,其中55名临床医生参与了采访.
- 数据收集的重点是临床医生报告的查实践和遵守国家指南.
主要成果:
- 94%的临床医生报告了30-65岁的平均风险患者的联合测试.
- 与指导方针一致的查率为联合测试的47%,单独进行HPV测试的82%,单独进行帕普测试的62%.
- 过度选在非执业的临床医生中很常见 (98%).
结论:
- 大多数临床医生使用联合测试,但遵守推的5年间隔是不一致的.
- 关于5年间隔的证据和适当的风险分层存在知识差距.
- 需要采取教育举措和改进的跟踪系统,以促进符合指南的查.
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