一位 24 歲女性因第一次子宮頸抹片檢查來到診所。護理師應解釋此項檢查是用來篩檢哪種疾病？
A 24-year-old female client is at the clinic for her first Pap smear. The nurse should explain that this test is used to screen for which condition?
- AEndometrial cancer子宮內膜癌
- BHuman papillomavirus (HPV) infection only僅人類乳突病毒（HPV）感染
- COvarian cancer卵巢癌
- DCervical cancer✓ 正解子宮頸癌
子宮頸抹片 (Pap smear) 是二級預防（早期篩檢）的典型例子，主要用於偵測子宮頸細胞的異常變化，從而早期發現子宮頸癌或癌前病變。選項 C (卵巢癌) 無法透過抹片發現；選項 A (內膜癌) 通常需透過超音波或切片；選項 B 雖然 HPV 是主因，但抹片主要是看細胞病理變化，而非單純檢測病毒存在（雖然現在常合併 HPV 檢測）。護理師應指導個案 21 歲起開始篩檢，即使已接種 HPV 疫苗，仍需定期檢查，因為疫苗無法涵蓋所有高風險病毒株。
The Pap smear is a classic example of secondary prevention (early screening), used mainly to detect abnormal cellular changes in the cervix in order to identify cervical cancer or precancerous lesions early. Option C (ovarian cancer) cannot be detected by Pap smear; option A (endometrial cancer) usually requires ultrasound or biopsy; and although in option B HPV is the main cause, the Pap smear primarily evaluates cellular pathologic changes rather than simply detecting the presence of the virus (though it is now often combined with HPV testing). The nurse should instruct individuals to begin screening at age 21 and to continue regular screening even if they have received the HPV vaccine, since the vaccine does not cover all high-risk strains.
美國指引建議 21 歲開始抹片，30 歲後可合併 HPV 檢測；台灣國健署則提供 30 歲以上女性每年一次免費抹片。美國護理師常需處理保險給付問題，台灣則需鼓勵年輕女性自費提前篩檢。