The remarkable success achieved in cervical cancer prevention is largely attributable to cervical cytology screening, also known as the Papanicolaou (Pap) test. The American Cancer Society (ACS) revised screening guidelines for Pap testing in 2002. The impact of these changes on future numbers of Pap tests has not been assessed. Using National Health Interview Survey (NHIS) data to determine historical screening patterns, we extrapolate the numbers of Pap tests that would be performed through 2010, under 5 different scenarios of implementation of screening guidelines. From 1993 to 2003, there was a steady increase in the number of Pap tests, with an estimated 65.6 million Pap tests performed in 2003. Approximately two thirds of women born after 1930 reported having been screened within the previous year, and 85% within the previous 3 years. Fifteen percent of Pap tests were performed in hysterectomized women, most of whom, according to current guidelines, should not be screened. Based on population projections, if screening behavior remains unchanged, 75 million Pap tests will be performed in 2010. Full compliance with ACS guidelines would approximately halve the total number of tests to 34 million. Potentially, with more appropriate allocation of resources according to guidelines, all women could be screened and the total number of Pap tests reduced, despite projected increases in the population.

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美国宫颈癌筛查率和筛查指南实施的潜在影响

在宫颈癌预防方面取得的显着成功很大程度上归功于宫颈细胞学筛查，也称为巴氏 (Pap) 测试。美国癌症协会 (ACS) 于 2002 年修订了巴氏试验的筛查指南。尚未评估这些变化对未来巴氏试验数量的影响。使用国家健康访问调查 (NHIS) 数据来确定历史筛查模式，我们推断在 5 种不同的筛查指南实施方案下，到 2010 年将进行的巴氏试验的数量。从 1993 年到 2003 年，巴氏试验的数量稳步增加，估计 2003 年进行了 6560 万次巴氏试验。 1930 年以后出生的妇女中约有三分之二报告在前一年接受过筛查，85%前3年。15% 的子宫颈抹片检查是在子宫切除的女性中进行的，根据当前的指南，其中大多数不应进行筛查。根据人口预测，如果筛查行为保持不变，2010 年将进行 7500 万次巴氏试验。完全遵守 ACS 指南将使检测总数减半至 3400 万。潜在地，根据指南进行更适当的资源分配，可以对所有女性进行筛查，并减少巴氏试验的总数，尽管人口预计会增加。完全符合 ACS 指南将使测试总数减半至 3400 万次。潜在地，根据指南进行更适当的资源分配，可以对所有女性进行筛查，并减少巴氏试验的总数，尽管人口预计会增加。完全符合 ACS 指南将使测试总数减半至 3400 万次。潜在地，根据指南进行更适当的资源分配，可以对所有女性进行筛查，并减少巴氏试验的总数，尽管人口预计会增加。