検体不適正率の通知による子宮頸がん集団検診の不適正検体の減少 Information of unsatisfactory rate to individual clinician in uterine cervical mass screening decreased unsatisfactory specimens

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<b>目的</b> : ベセスダ方式の導入で, 標本の適正・不適正が評価されるようになった. 不適正標本の減少のため, 検体採取医にみずからの不適正発生率を通知し, 改善効果を検討した.<br><b>方法</b> : 福島県内の子宮頸がん集団検診で, 施設検診を行った 114 施設に, 2009 年 4 月∼2010 年 3 月の各施設の不適正率を報告した. 次いで 2010 年 4 月∼2011 年 3 月の 114 施設の不適正率の推移を比較した.<br><b>成績</b> : 2009 年 4 月∼2010 年 3 月の不適正率は 51,863 件中 3,529 件, 6.8%であったが, 2010 年 4 月∼2011 年 3 月は 56,162 件中 1,875 件, 3.3%で有意に減少した.<br>不適正標本が有意に減少した施設は 54 (47.4%), 有意ではないが減少した施設は 42 (36.8%) であった.<br>改善施設では, 一部は綿棒採取をやめたことで, 不適正検体が著しく減少した施設もあったが, 従来からスパーテル, ブラシ採取であった施設でも多くで改善がみられた.<br><b>結論</b> : 施設ごとの不適正発生率を報告することで, 検体採取医が採取器具を変更したり, 検体採取時に留意を促すことで, 不適正標本の減少が期待できる.

<b><i>Objective</i></b> : The Bethesda System (TBS) defines the adequacy of cytology specimens. We informed individual clinicians about the rate of unsatisfactory smears in uterine cancer screening. Subsequently, we conducted an investigation to determine if the provision of this information had led to a decrease in the rate of unsatisfactory smears.<br><b><i>Study Design</i></b> : We informed individual clinicians about the rate of unsatisfactory smears in mass screening for uterine cancer from April 2009 to March 2010. After the provision of this information during the aforementioned period, we investigated whether there was any improvement in the rate of unsatisfactory smears in the following years, that is, from April 2010 to March 2011.<br><b><i>Results</i></b> : The number of unsatisfactory specimens during the first period was 3,529 (6.8% in 51,863 participants). Investigation in the following years, after individual clinicians had been provided information about the rate of unsatisfactory smears, the number of unsatisfactory smears was found to have reduced to 1,875 (3.3% in 56,162 participants). Thus, provision of information about the rate of unsatisfactory smears to individual clinicians was followed by a significant reduction in the rate of unsatisfactory smears in uterine cancer screening (p<0.0001). The rate of unsatisfactory smears decreased significantly for physicians who discontinued cotton swab collection.<br><b><i>Conclusion</i></b> : Provision of information about the rate of unsatisfactory smears to individual clinicians decrease of the rate of unsatisfactory smears. The reasons for the decrease in the rate of unsatisfactory smears following provision of information about the rate to individual clinicians were attempt by the physicians to provide specimens of improved quality and discontinuation of cotton swab collection.

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  • 日本臨床細胞学会雑誌

    日本臨床細胞学会雑誌 52(4), 330-334, 2013-07-22

    特定非営利活動法人 日本臨床細胞学会

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各種コード

  • NII論文ID(NAID)
    10031178621
  • NII書誌ID(NCID)
    AN00198721
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    03871193
  • データ提供元
    CJP書誌  J-STAGE 
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