Suivi par les médecins généralistes des frottis cervico-utérins classés ASC-US (notice n° 1578604)
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| fixed length control field | 04704cam a2200421 4500500 |
| 005 - DATE AND TIME OF LATEST TRANSACTION | |
| control field | 20251228045449.0 |
| 041 ## - LANGUAGE CODE | |
| Language code of text/sound track or separate title | fre |
| 042 ## - AUTHENTICATION CODE | |
| Authentication code | dc |
| 100 10 - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Giuria, Clara |
| Relator term | author |
| 245 00 - TITLE STATEMENT | |
| Title | Suivi par les médecins généralistes des frottis cervico-utérins classés ASC-US |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Date of publication, distribution, etc. | 2015.<br/> |
| 500 ## - GENERAL NOTE | |
| General note | 54 |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Objectif : Devant un frottis cervico-utérin classé ASC-US ( Atypical Squamous Cells of Undetermined Significance), la Haute Autorité de santé préconise au choix en premier contrôle : la colposcopie, le frottis à six mois, la recherche d’HPV ( Human Papilloma Virus) à haut risque oncogène. L’objectif principal était de connaître l’option choisie par les médecins généralistes et d’évaluer le suivi de ces frottis. Méthodes : La base de données de l’organisme du dépistage des cancers du Maine-et-Loire a été utilisée pour extraire 283 dossiers de femmes, âgées de 25 à 65 ans, ayant eu un frottis ASC-US en 2011 pratiqué par un médecin généraliste (MG).Résultats : Dans notre échantillon, 265 femmes (93,6 %) ont eu un premier contrôle (C1). Les MG en ont effectué 64,5 % : 93 % étaient des frottis, 5,3 % des tests HPV et 1,7 % des frottis couplés à un test HPV. Cinquante-huit pour cent des femmes ont eu un suivi complet, c’est-à-dire deux contrôles après le premier frottis ASC-US, ou une intervention thérapeutique après C1 anormal. Quatorze (4,9 %) ont été perdues de vues. Le taux de suivi était de 57,6 % avec C1 normal et de 83,3 % avec C1 anormal. Les résultats de 79,2 % des C1 étaient normaux et au total, 16 lésions de haut grade ont été diagnostiquées (5,7 %). Conclusions : L’utilisation minoritaire du frottis en phase liquide peut expliquer la faible prescription du test HPV. La rareté de l’anomalie ASC-US, la variabilité du potentiel évolutif et une latitude dans les options de suivi contribuent aux difficultés d’application des recommandations. Le manque de coordination entre gynécologues et MG, les difficultés à planifier le suivi, l’imprécision des comptes-rendus des résultats peuvent être des facteurs limitant l’efficience de la surveillance. |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Aim: In the event of an ASC-US Pap smear, colposcopy, 6-month Pap smear or screening for oncogenic HPV are recommended as first-line testing options by the French National Authority for Health –HAS. The primary objective of this study was to determine the preferred option chosen by general practitioners and to assess their follow-up care. Methods: The Maine-et-Loire cancer screening database was used to extract 283 files of women, aged 25 to 65, in whom ASC-US Pap smear was performed by their general practitioners (GPs) in 2011. Results: 265 women (93.6%) underwent their first test (C1). GPs performed 64.5% of tests: 93% of which were Pap smears, 5.3% were HPV tests and 1.7% were Pap smears combined with HPV tests. 164 patients (58%) received comprehensive follow-up, i.e 2 tests after the first ASC-US pap smear or a therapeutic intervention after an abnormal C1. 14 patients were lost to follow-up. Follow-up rate was 57.6% in the case of a normal C1 and 83.3% in the case of an abnormal C1.79.2% of first tests were normal and a total of 16 high-grade lesions were diagnosed (5.7%). Conclusion: The fact that liquid-based Pap smears were rarely used might explain why HPV testing is rarely prescribed. The rarity of ASC-US anomalies, the variable potential for progression and the possibility to choose between several follow-up options proved to be obstacles for GPs to apply guidelines. The poor coordination between gynaecologists and GPs, the difficulties in planning follow-up and the lack of precision of test reports may limit the efficacy of monitoring. |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | ASC-US |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | dépistage |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | dysplasie du col uterin |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | étude descriptive |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | études de validation |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | femmes |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | frottis cervico-utérin |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | Médecine générale |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | ASC-US |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | atypical squamous cells of the Cervix |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | cervical pap smear |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | descriptive study |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | general practice |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | papanicolaou test |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | screening |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | validation studies |
| 690 ## - LOCAL SUBJECT ADDED ENTRY--TOPICAL TERM (OCLC, RLIN) | |
| Topical term or geographic name as entry element | women |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Guiheneuc, Elise |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Coimet, Flore |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Caillez, Eric |
| Relator term | author |
| 700 10 - ADDED ENTRY--PERSONAL NAME | |
| Personal name | Baron, Céline |
| Relator term | author |
| 786 0# - DATA SOURCE ENTRY | |
| Note | Santé Publique | 27 | 5 | 2015-12-18 | p. 659-667 | 0995-3914 |
| 856 41 - ELECTRONIC LOCATION AND ACCESS | |
| Uniform Resource Identifier | <a href="https://stm.cairn.info/revue-sante-publique-2015-5-page-659?lang=fr&redirect-ssocas=7080">https://stm.cairn.info/revue-sante-publique-2015-5-page-659?lang=fr&redirect-ssocas=7080</a> |
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