Analysis of Missed Diagnosis of Cervical Cancer_West China Medical Journal

Authors：

CHEN Fuxia ,  FANG Fang , FENG Dan

Department of Gynaecology, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

FANG Fang, Email: redpeachand@163.com

Keywords：

宮頸癌; 漏診; 誤診; 宮頸篩查

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目的　探討宮頸癌漏診的原因及特點，提高首診診斷率。方法　回顧性分析2009年1月－2011年3月收治的外院漏診的65例宮頸癌患者臨床資料。結果　漏診的65例中有51例誤診為宮頸糜爛，其中僅13例首診曾行細胞學篩查，16例行陰道鏡檢查及活檢，總平均年齡僅39歲，農村居民54例。結論　各地區應加強宮頸癌篩查意識，采取相應措施及適合的篩查方式提高宮頸癌篩查率，減少漏診。

Citation： CHEN Fuxia,FANG Fang,FENG Dan. Analysis of Missed Diagnosis of Cervical Cancer. West China Medical Journal, 2012, 27(4): 564-566. doi: Copy

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4.	Everett T, Bryant A, Griffin MF, et al. Interventions targeted at women to encourage the uptake of cervical screening[J]. Cochrane Database Syst Rev, 2011(5): CD002834.
5.	IARC Working Group on evaluation ofcervical cancer screening programmes. Screening for squamous cervical cancer: duration of low risk after negative results of cervicalcytology and its implication for screening policies[J]. Br Med J, 1986, 293(6548): 659-664.
6.	田淑貞, 竇拉加. HPV檢測和TCT在宮頸病變篩查及治療后隨訪中的應用[J]. 腫瘤基礎與臨床, 2009, 22(5): 455-457.
7.	Siebers AG, Klinkhamer PJ, Grefte JM, et al. Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors:a randomized controlled trial[J]. JAMA, 2009, 302(16): 1757-1765.
8.	Ronco G, Cuzick J, Pierotti P, et al. Accuracy of liquid based versus conventional cytology:overall results of new technologies for cervical cancer screening:randomised controlled trial[J]. BMJ, 2007, 335(7609): 28.
9.	de Sanjose S, Quint WG, Alemany L, et al. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study[J]. Lancet Oncol, 2010, 11(11): 1048-1056.
10.	Mayrand MH, Duarte-Franco E, Rodrigues I, et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer[J]. NEJM, 2007, 357(16): 1579-1588.
11.	Wright TC Jr, Schiffman M, Solomon D, et al. Interim guidance for the use of human papillomavirus DNA testing as an adjunct to cervical cytology for screening[J]. Obstet Gynecol, 2004, 103(2): 304-309.
12.	Reich O, Pickel H, Tamussino K, et al. Microinvasive carcinoma of the cervix: site of first focus of invasion[J]. Obstet Gynecol, 2001, 97(6): 890-892.
13.	Solomon D, Stoler M, Jeronimo J, et al. Diagnostic utility of endocervical curettage in women undergoing colposcopy for equivocal or low-grade cytologic abnormalities[J]. Obstet Gynecol, 2007, 110(2): 288-295.

1. 　Parkin DM, Bray F, Ferlay J, et al. Global cancer statistics, 2002[J]. CA Cancer J Clin, 2002, 55(2): 74-108.
2. 　Peto J, Gilham C, Fletcher O, et al. The cervical cancer epidemic that screening has prevented in the UK[J]. Lancet, 2004, 364(9430): 249-256.
3. 　Sauvaget C. Fayette JM. Muwonge R, et al. Accuracy of visual inspection with acetic acid for cervical cancer screening[J]. Int J Gynecol Obstet, 2011, 113(1): 14-24.
4. 　Everett T, Bryant A, Griffin MF, et al. Interventions targeted at women to encourage the uptake of cervical screening[J]. Cochrane Database Syst Rev, 2011(5): CD002834.
5. 　IARC Working Group on evaluation ofcervical cancer screening programmes. Screening for squamous cervical cancer: duration of low risk after negative results of cervicalcytology and its implication for screening policies[J]. Br Med J, 1986, 293(6548): 659-664.
6. 　田淑貞, 竇拉加. HPV檢測和TCT在宮頸病變篩查及治療后隨訪中的應用[J]. 腫瘤基礎與臨床, 2009, 22(5): 455-457.
7. 　Siebers AG, Klinkhamer PJ, Grefte JM, et al. Comparison of liquid-based cytology with conventional cytology for detection of cervical cancer precursors:a randomized controlled trial[J]. JAMA, 2009, 302(16): 1757-1765.
8. 　Ronco G, Cuzick J, Pierotti P, et al. Accuracy of liquid based versus conventional cytology:overall results of new technologies for cervical cancer screening:randomised controlled trial[J]. BMJ, 2007, 335(7609): 28.
9. 　de Sanjose S, Quint WG, Alemany L, et al. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study[J]. Lancet Oncol, 2010, 11(11): 1048-1056.
10. 　Mayrand MH, Duarte-Franco E, Rodrigues I, et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer[J]. NEJM, 2007, 357(16): 1579-1588.
11. 　Wright TC Jr, Schiffman M, Solomon D, et al. Interim guidance for the use of human papillomavirus DNA testing as an adjunct to cervical cytology for screening[J]. Obstet Gynecol, 2004, 103(2): 304-309.
12. 　Reich O, Pickel H, Tamussino K, et al. Microinvasive carcinoma of the cervix: site of first focus of invasion[J]. Obstet Gynecol, 2001, 97(6): 890-892.
13. 　Solomon D, Stoler M, Jeronimo J, et al. Diagnostic utility of endocervical curettage in women undergoing colposcopy for equivocal or low-grade cytologic abnormalities[J]. Obstet Gynecol, 2007, 110(2): 288-295.

West China Medical Journal

Analysis of Missed Diagnosis of Cervical Cancer

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