Lege Artis Medicinae

[What we heard at the LAM club; Tools for reconciliation in the health sector]

KRASZNAI Éva

DECEMBER 29, 1993

Lege Artis Medicinae - 1993;3(12)

[In addition to an interested participation of professionals, "Tools for reconciliation in the health sector" was the topic of the LAM Club meeting in early October. The topicality of the subject was the events at the intensive care unit of the Imre Haynal University of Science - the nurses' strike. The evening was hosted by István Kamenitzky, a member of the Board of the Health Insurance Self-Government. Invited guests were Endre Bor dán, Head of the Department of the Ministry of Public Welfare, Judit Gulyás, President of the EDDSZ, József Kovács, one of the best experts in medical ethics in Hungary, and Erzsébet Rozsos, Head of the Ethics Committee of the Nursing Association. ]

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[ From 1980 to 1991, 1379 women with abnormal colposcopic and/or cytologic findings were examined at the Department of Gynecological Oncology at the National Institute of Oncology, Budapest. The sensitivity and specificity of these screening tests were studied retrospectively. All women underwent either cervical excision or conisation. Cytological and colposcopical findings were compared with the histological findings. Sensitivity and specificity of cytology were 49% and 77%, retrospectively. The corresponding figures for colposcopy were 88% and 12%, and for cytology and colposcopy together, 96% and 14%. 1. The low sensitivity of cytology suggests that as many as 50% of CIN lesions will be missed if cytology alone is used for screening. This finding probably justifies our screening policy (i. e., colposcopy should be used as a primary tool). 2. We found 194 asymptomatic patients with carcinoma in situ, 40 with microinvasive and 8 with frank invasive carcinoma. This finding emphasizes the importance of cervical cancer screening. 3. To decrease the false positive and negative rates, the introduction of new scientific results into the every day screening practice is urgently needed. 4. Our data suggest the superiority of a colposcopical screening method to a cytological one; however histological examination must be done independently of a screening method if the suspicion of cervical dysplasia arises. ]

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