Review on Natural History and Screening of Cervical Cancer in Taiwan

子宮頸癌自然病史與台灣子宮頸癌篩檢的文獻回顧

周碧瑟(Pesus Chou)

《中華民國公共衛生學會雜誌》 10卷3&4期 (1990/12) Pp. 123-131

https://doi.org/10.6288/JNPHARC1991-10-0304-01

摘要

本文針對子宮頸癌自然病史與台灣子宮頸癌篩檢作文獻回顧。子宮頸癌是個持續漸進的疾病，起始於原位癌，經二、三十年後轉變為臨床上的侵襲癌，這自然病史中，在侵襲癌發作之前，約有一、二十年的時間可供偵測或去除。若有篩檢計劃介入，由篩檢發現的無症狀病例會有一段引導期。台灣子宮頸癌篩檢計劃分兩個階段實施，本文描述了計劃內容與主要發現。針對頭十年的篩檢結果之評詁，中華民國防癌協會頭十年的子宮頸癌篩檢計劃已顯現其效果。本文亦估算出1974-1984年間台灣子宮頸癌篩檢計劃的精確度，陽性結果預期值與癌症率。細胞學檢驗室的標準化與品質管制是子宮頸癌篩檢準確性的最重要課題，台灣子宮頸癌的防治有賴於提高受檢率與陽性結果之徹底追蹤診治。

並列摘要

This article reviews literature of natural history of cervical cancer and cervical cancer screening in Taiwan. Carcinoma of the cervix is a progressive disease beginning with in situ changes and ending 2 or 3 decades later with clinical invasive cancer, and that there is a period of time of approximately one or two decades within this natural history when the disease may be identified, removed, or reversed prior to the onset of invasive cancer. If a screening program is introduced, every asymptomatic case detected in a screening program experiences some lead time. The cervical cancer screening program in Taiwan was carried out in two phases. Program description and major findings were described. The evaluation study suggested that the first ten-year screening program in Taiwan conducted by the Cancer Society of the Republic of China has been effective. The specificity, predictive value, and cancer detection rate of screening for cervical cancer in Taiwan, 1974-1984, were estimated. Standardization and quality control of the cytopathological laboratory is the most important issue in the accuracy of screening for cervical cancer. How to increase the examination rate and complete follow-up for those women with abnormal smears are the key issues in the control of cervical cancer in Taiwan.

並列關鍵字

Review ； Natural history ； Cervical Cancer ； Screening