Inequalities in cervical cancer screening in Eastern Europe: perspectives from Bulgaria and Romania
Inequalities in cervical cancer screening in Eastern Europe: perspectives from Bulgaria and Romania
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DOI：
10.1007/s00038-009-8040-6
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发表时间：
2009-08-01
影响因子：
4.6
通讯作者：
Bradley, Janet
中科院分区：
文献类型：
--
作者：
Todorova, Irina;Baban, Adriana;Bradley, Janet
东欧的宫颈癌发病率一直在上升，与西欧大多数国家的发病率下降形成鲜明对比。本文的目的是描述罗马尼亚和保加利亚在宫颈癌筛查方面的不平等，并找出造成这些不平等的原因。通过结构化问卷对保加利亚和罗马尼亚的代表性样本--保加利亚的1099人和罗马尼亚的1053人--进行了访谈。我们发现了宫颈癌患病率和预防方面的多个方面的不平等，包括与其他国家相比的差异，由于社会经济地位、教育、居住地和种族的差异，以及妇女在获得筛查机会和与提供者的关系方面面临的不同障碍。我们确定了社会经济地位对筛查历史的影响的中介因素。研究得出结论，社会经济地位对筛查的影响主要是通过获得医疗保健系统的结构性障碍以及女性对涂抹的多重成本的看法来中介的。这些结论与两国国家筛查计划的发展和健康促进有关。
The incidence of cervical cancer in Eastern Europe has been on the rise, in contrast to the reduction in incidence in most countries of Western Europe. The objectives of the paper are to delineate the inequalities in cervical cancer screening in Romania and Bulgaria and identify explanations for these inequalities.Representative samples of women - 1 099 in Bulgaria and 1 053 in Romania, were interviewed through a structured questionnaire.We found multiple dimensions of inequalities in cervical cancer prevalence and prevention, including disparities in comparison to other countries, disparities due to socioeconomic status, education, residency and ethnicity, as well as differential barriers faced by women in access to screening and in relationships with providers. We identified mediators of the effects of socio-economic status on screening history.The study concludes that the effect of SES on screening is mediated mainly by the structural barriers in accessing the healthcare system, as well as women's perceptions of the multiple costs of the smear. These conclusions are relevant to the development of national screening programs and health promotion in the two countries.