JAMA Intern Med:对小于21岁年轻女性及因良性病变行子宫全切者

2013-04-19 姜珊 编译 中国医学论坛报

  美国学者提出,在小于21岁年轻女性及因良性病变行子宫全切者中,行巴氏试验具有明确的风险而无确证的益处;循证医学临床指南建议,在这些女性中不应施行该检查。在这些女性中行巴氏试验检查的年花费约为8.5亿美元。对于特定的高危人群,包括有宫颈癌病史或高分级宫颈病变者、暴露于宫内己烯雌酚者、免疫功能低下或人类免疫缺陷病毒感染者,筛查可能是恰当的。该论文4月8日在线发表于《美国医学会杂志·内科学》(JAM

  美国学者提出,在小于21岁年轻女性及因良性病变行子宫全切者中,行巴氏试验具有明确的风险而无确证的益处;循证医学临床指南建议,在这些女性中不应施行该检查。在这些女性中行巴氏试验检查的年花费约为8.5亿美元。对于特定的高危人群,包括有宫颈癌病史或高分级宫颈病变者、暴露于宫内己烯雌酚者、免疫功能低下或人类免疫缺陷病毒感染者,筛查可能是恰当的。该论文4月8日在线发表于《美国医学会杂志·内科学》(JAMA Intern Med)。


No Papanicolaou Tests in Women Younger Than 21 Years or After Hysterectomy for Benign Disease
In 2010, the National Physicians Alliance (NPA) with the support of the American Board of Internal Medicine Foundation convened the Good Stewardship Working Group, consisting of a representative sample of practicing primary care physicians selected from a variety of practice settings as well as geographic locations around the United States. Their goal was to identify the top 5 common outpatient practices in general pediatrics, general internal medicine, and family medicine for which there was evidence supporting the lack of benefit as well as potential increased risk.1
We review herein the data supporting the recommendation from general internal medicine and family medicine: do not perform Papanicolaou tests on patients younger than 21 years or in women after hysterectomy for benign disease....

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