screening

Gynecological Cancer Screening and Tracking Skill

Screening plan management and result tracking for cervical cancer, ovarian cancer, and endometrial cancer.

Core Workflow

用户输入 → 识别操作类型 → [hpv/tct] 解析结果 → 风险评估 → 保存记录
                              ↓
                         [co-testing] 解析联合结果 → 综合评估 → 保存
                              ↓
                         [marker] 解析肿瘤标志物 → 趋势分析 → 保存
                              ↓
                         [status/next] 读取数据 → 显示报告

Step 1: Parse User Input

Operation Type Identification

Input Keywords	Operation Type
hpv, HPV	hpv - Record HPV test
tct, TCT	tct - Record TCT test
co-testing	co-testing - Joint screening
marker	marker - Tumor marker
abnormal	abnormal - Abnormal result follow-up
status	status - View screening status
next	next - Next screening reminder

Step 2: Parameter Parsing Rules

HPV Result Identification

User Input	Standard Result
negative	negative
positive	positive
16, 18, 31, 33, 52, 58	HPV type

HPV Type Classification

Risk Level	HPV Type
High Risk (Highest Risk)	16, 18
High Risk (Other)	31, 33, 35, 39, 45, 51, 52, 56, 58, 59
Low Risk	6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81

TCT Result Identification (Bethesda System)

User Input	Standard Result	Risk
NILM	NILM	Normal
ASC-US	ASC-US	Low
ASC-H	ASC-H	Medium-High
LSIL	LSIL	Low-Medium
HSIL	HSIL	High
AGC	AGC	Medium-High
cancer	Cancer	Very High

Tumor Marker Identification

Marker	Related Cancer	Normal Value
CA125	Ovarian cancer, endometrial cancer	<35 U/mL
CA19-9	Ovarian cancer, endometrial cancer	<37 U/mL
CEA	Endometrial cancer	<5 ng/mL
AFP	Yolk sac tumor	<10 ng/mL

Step 3: Risk Assessment

HPV Negative

✅ HPV阴性
风险评估：低
管理建议：继续常规筛查

HPV 16/18 Positive (Highest Risk)

🚨 HPV 16/18阳性（最高危）
风险评估：高
立即行动：立即进行阴道镜检查

Other High-Risk HPV Positive

⚠️ 高危HPV阳性
风险评估：中-高
管理建议：1年后复查 或 立即阴道镜

Interpretation of Abnormal TCT Results

ASC-US

⚠️ TCT结果：ASC-US
风险评估：CIN 2+风险约5-10%
管理方案：反射HPV检测

LSIL

⚠️ TCT结果：LSIL
风险评估：CIN 2+风险约15-20%
管理方案：1年后复查TCT+HPV

HSIL

🚨 TCT结果：HSIL
风险评估：CIN 2+风险>50%
立即行动：立即阴道镜检查+活检

Co-testing Result Management

HPV	TCT	Risk	Management
Negative	NILM	Very low	Repeat in 5 years
Positive 16/18	Any TCT	High	Immediate colposcopy
Positive other	NILM	Low-medium	Repeat in 1 year
Positive other	ASC-US	Medium	Colposcopy or repeat in 1 year
Negative	ASC-US	Low	Repeat in 3 years

Step 4: Generate JSON

HPV Test Record

{
  "last_hpv": "2025-01-15",
  "hpv_result": "positive",
  "hpv_type": "16",
  "hpv_risk_level": "high",
  "next_screening_type": "colposcopy",
  "days_until_next": 0
}

TCT Test Record

{
  "last_tct": "2025-01-15",
  "tct_result": "ASC-US",
  "tct_result_full": "非典型鳞状细胞，意义不明确",
  "tct_bethesda_category": "ASC-US"
}

Tumor Marker Record

{
  "CA125": {
    "current_value": 15.5,
    "reference_range": "<35",
    "unit": "U/mL",
    "last_checked": "2025-06-20",
    "classification": "normal",
    "trend": "stable"
  }
}

Step 5: Save Data

1. Read data/screening-tracker.json
2. Update the corresponding record section
3. Write back to file

Screening Strategy

Age-Stratified Screening

Age	Screening Strategy	Screening Interval
21-29 years	TCT alone	Every 3 years
30-65 years	HPV+TCT co-testing	Every 5 years
Or TCT alone		Every 3 years

High-Risk Population

Population Type	Screening Frequency
HIV positive	Once per year
Immunosuppression	Once per year
History of cervical cancer	Once per year
DES exposed	Once per year

For more examples, see examples.md。