子宮頸癌一直為?性健康的最大威脅之一，1996 ?至2003 ?子宮頸癌發生?一直位居台灣?性癌症發生?第一名，有鑑於此，政府對於子宮頸癌的預防及治?，均有許多的投入與討?。因此本研究將分三?，探討子宮頸癌篩檢及治?的效?評估。台灣政府從民國 84 ?開始提供30 歲以上婦?每?一次免費子宮頸抹片篩檢服務，近幾??明顯看到篩檢對於國內子宮頸癌帶?明顯的成效。在篩檢?方面，從84 ?的 20%上升至94 ?的53.8%。雖然子宮頸抹片篩檢?逐漸提昇，但仍有很大的努?空間。因此針對婦??願意進?篩檢與有接受篩檢習慣之婦?的相關原因相比較，將是我們急需?解的重點。因此本研究第一?的重點將針對子宮頸抹片篩檢頻??同的婦?(??篩檢，三?一次，??一次，十?一次，未曾篩檢)，?用PERCEDE MODEL 進?訪問，探討其接受及未接受子宮頸抹片篩檢之相關影響因素。研究將透過醫師協助，於全國多家醫院門診及住院進?問卷調查，預計回收有效問卷500 分。研究將?用描述性與雙變項分析，?解?同篩檢頻?(??抹片、三?內有抹片、三至??內有抹片、?至十?內有抹片、從未接受抹片)之婦?，其相關影響因素之差?。而除?預防篩檢外，政府在子宮頸癌?床治?方面也投入相當多的研究。子宮頸癌初始治?原則以手術治?與放射線治?為主，但2000 ?時，美國癌症協會（American national cancer institute；NIC）提出同步化學放射線治?，內容是所有施?放射線治?之子宮頸癌患者必須伴隨化學藥物治?(CCRT)，此新的治?方式目前已廣泛的被採用。但截至目前為止，鮮少有研究針對CCRT 治?進?成本效?或者是婦?生活品質之探討。因此本研究第二?將?用EORTC QLQ-Cx24 問卷，比較CCRT 與非CCRT 病患、與子宮?除與否病患之生活滿意?之差?。此部份將於全國多家醫院婦產科門診及住院進?問卷訪問，預計回收有效問卷300 份。?用雙變項分析與回歸分析，?解影響病患生活品質之相關因素。研究第三?為?用治?費用與存活天?探討，將?用中區某醫學中心 2005 ?至 2012 ?之子宮頸癌病?資?檔與癌症登記檔等相關資?，比較CCRT 與非CCRT 病患、與子宮?除與否其病患存活天?、醫?花費、成本效?之差?。 Cervical cancer is one of the leading causes of cancer death among women in most countries in the world. According to the reports from the Bureau of National Health in 2009, cervical cancer is the sixth leading cause of female cancer deaths in Taiwan. The government in Taiwan had put lots of efforts in cervical cancer prevention and treatment for years. This study is a 3 years study; the objective of the study is going to analysis the effectiveness of cervical cancer screening and treatment. Taiwan implemented free cervical cancer screening every year for women aged 30 years old since year 1995. However, the participant rate only increased from 20% in year 1995 to 53.8% in year 2005. Comparing to the 85.2% screening rate in USA, we still have place to go. Therefore, this first year study will interview the women aged 35 years and older, and understands their attitude about cervical cancer screening. The study will conduct the structured questionnaire in outpatient and inpatient department in several hospitals in Taiwan. The study will base on PERCEDE MODEL to conduct the interview, and expect to receive 500 effective questionnaires. The study will compare the different attitude and characteristics among women with different screening frequency. Besides screening, the government also put lots of efforts on cervical cancer treatment. The principle treatment for cervical cancer was surgery and assisted by radiotherapy. In year 2000, American National Cancer Institute announced a new treatment method for cervical cancer patients- CCRT. CCRT was the most popular treatment method in treating cervical cancer during these years. There are several studies compared the clinical outcomes for CCRT, however, few of them focused on the quality of life and cost-effectiveness analysis. Therefore, the 2nd year study will compare the patients’ quality of life under different treatment methods. The EORTC QLQ-Cx24 questionnaire will be conducted in the inpatient and outpatients departments in several hospitals in Taiwan. Expected of 300 effective questionnaire will be received by the study. The t-test and multiple regression analysis will be conducted to compare the patients’ quality of life with different treatment. The 3rd year study will compare the cost-effectiveness of different treatment (CCRT/non-CCRT, hysterectomy/non hysterectomy). The cervical cancer patients between years 2005 and 2012 will be the study’s subjects. Patients’ medical information will be extracted by doctors for the study. The study will compare patients’ survival status, medical cost, and cost-effectiveness under different treatment.
