中国农村妇女两癌检查项目服务能力现状分析  

Service capacity for implementing cervical and breast cancer screening programs among rural women in China

作　　者：马兰[1] 宋波[1] 吴久玲[1] 狄江丽[1] 赵艳霞[1] 陈静宜[1] 罗晓敏[1] MA Lan;SONG Bo;WU Jiu-ling(National Center for Women and Chidren＇s Health,Chinese Center jbr Disease Control and Prevention,Beijing 100081,China)

机构地区：[1]中国疾病预防控制中心妇幼保健中心妇女卫生保健部,北京100081

出　　处：《中国公共卫生》2018年第9期1250-1253,共4页Chinese Journal of Public Health

摘　　要：目的分析中国部分省份宫颈癌、乳腺癌(以下简称两癌)检查项目机构服务现状,为制定下一步两癌检查方案提供参考。方法利用自行设计的医疗机构调查表,于2014—2015年,在全国12省19县参与两癌检查项目的123家医疗保健机构进行调查,了解其项目开展、人员构成等现状。结果项目开展方面,县级开展乳腺临床、乳腺彩超检查、阴道镜检查、液基/薄层细胞学检查、醋酸和卢戈碘液染色肉眼观察(VIA/NILI)检查、宫颈细胞伯塞斯达系统(TBS)分类诊断、病理检查、乳腺X线检查和人类乳头瘤病毒(HPV)检测的机构比例远高于乡级;东中部地区开展妇科检查、阴道/宫颈分泌物实验室检查、宫颈细胞TBS诊断、阴道镜检查和乳腺临床检查的机构比例高于西部;医务人员构成方面,东部以县级医务人员为主(63.7%),中、西部则以乡级为主(70.0%、77.1%);医务人员职称方面,县级医疗机构以中级职称为主(30.8%),乡级则以初级职称为主(43.1%),东部地区以中级职称为主(27.1%),中、西部则以初级职称为主(41.4%、54.6%)。结论两癌项目地区工作流程符合要求,不同级别机构和不同地区机构及人员能力发展不均衡,基层服务人员能力有待进一步提高。Objective To analyze current situation of cervical and breast cancer screening service among rural women and conditions of the medical institutions and staff providing the service in China and to provide references for implementing cervical and breast cancer screening programs. Methods We conducted a survey on staff composition of 123 medical institutions randomly selected in 19 counties of 12 provinces across China and cervical and breast cancer screening services provided by the institutions among rural women between 2014 and 2015. A self-designed questionnaire was used in the study. Results The cervical and breast cancer screening services provided by the medical institutions to the rural women were as following： physical examination and color Doppler ultrasonography of breast, colposcopy, liquid-based/thin layer cytology test, visual inspection with acetic acid/Lugol＇s iodine（VIA/VILI）, classification/diagnosis of cervical cytology with the Bethesda system（TBS）, pathological examination, mammogram, and human papillomavirus detection. During the period,the county-level medical institutions implemented much more cervical and breast cancer screening services to the rural women than the township-level institutions; the medical institutions in eastern and central regions of China implemented more gynecologic examinations, cervix secretion and cervical wecretion examination, cervical cytology TBS diagnosis,colposcopy, and breast physical examination than the institutions in western regions of China. In eastern regions of China, the majority（63.7%） of the personnel engaged in cervical and breast cancer screening programs were the employees of countylevel medical institutions; while in central and western regions, the majorities（70.0% and 77.1%） were the employees of township-level institutions. For the screening program-relevant personnel from county-level medical institutions, 30.8% had intermediate professional title; but for the personnel from township-level institutions, 43.1% had primary tit

关 键 词：宫颈癌 乳腺癌 筛查项目 服务能力 

分 类 号：R737.3[医药卫生—肿瘤]