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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >Process of care failures in invasive cervical cancer: systematic review and meta-analysis.
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Process of care failures in invasive cervical cancer: systematic review and meta-analysis.

机译：浸润性宫颈癌护理失败的过程：系统评价和荟萃分析。

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OBJECTIVE: As invasive cervical cancer is preventable when screening and treatment of pre-invasive lesions are timely and appropriate, several past studies attempted to enumerate the quality of preventive care invasive cervical cancer subjects received before diagnosis. Objectives of the present study were to review and to summarize the findings of these studies in a meta-analysis. METHOD: Data from 42 studies were used to estimate DerSimonian and Laird random effects models for the various failures in care along the cancer care continuum. Analyses were also conducted within strata characterized by variables deemed to account for heterogeneity in meta-regression analyses. RESULTS: Poor Pap screening frequency was the primary factor attributable to development of invasive cervical cancer. On average, 53.8% (95% confidence interval: 43.6-66.3) of invasive cervical cancer subjects had inadequate screening histories and 41.5% (95% confidence interval: 35.4-48.7) were never screened. There was significant temporal improvement in the proportion of women screened at least once over a lifetime but not in the proportion with overall deficient histories. An estimated 29.3% (95% confidence interval: 21.2-40.4) of failures to prevent invasive cervical cancer can be attributed to false-negative Pap smears and 11.9% (95% confidence interval: 9.0-15.6) to poor follow-up of abnormal results. CONCLUSION: Appropriate assessment of the effect of combined failures in the process of care must be done in comprehensive audit studies.
机译：目的：由于及时，适当地筛查和治疗浸润前病变可以预防浸润性宫颈癌，因此过去的一些研究试图枚举诊断前接受浸润性宫颈癌受试者的预防保健质量。本研究的目的是在荟萃分析中回顾和总结这些研究的结果。方法：从42项研究中获得的数据用于估计沿癌症护理连续性的各种护理失败的DerSimonian和Laird随机效应模型。在以变量为特征的分层中也进行了分析，这些变量被认为是在元回归分析中解释了异质性的原因。结果：子宫颈抹片检查频率低是导致浸润性宫颈癌发展的主要因素。平均而言，有53.8％（95％置信区间：43.6-66.3）的浸润性宫颈癌受试者的筛查历史不充分，并且从未进行过筛查的有41.5％（95％置信区间：35.4-48.7）。一生中至少接受过一次筛查的妇女比例在时间上有显着改善，但在整体病史不足的情况下则没有。估计29.3％（95％置信区间：21.2-40.4）预防浸润性宫颈癌失败可归因于假阴性子宫颈抹片检查，而11.9％（95％置信区间：9.0-15.6）归因于对异常的不良随访结果。结论：必须在综合审核研究中适当评估护理过程中合并失败的影响。

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