Community-based cultural predictors of pap smear screening in Nova Scotia
Community-based cultural predictors of pap smear screening in Nova Scotia
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DOI：
10.1007/bf03405774
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发表时间：
2004-03-01
影响因子：
4.3
通讯作者：
MacIsaac, MA
中科院分区：
文献类型：
--
作者：
Johnston, GM;Boyd, CJ;MacIsaac, MA
背景：巴氏涂片筛查能有效降低宫颈癌的发病率。然而，一些女性亚群比其他亚群更不可能接受筛查。由于加拿大各省卫生数据库不包含识别种族或语言的数据字段，使用这些变量的分析通常不可用。本文通过使用基于社区而不是基于个人的措施来克服这一问题。根据社区收入、语言、种族、城乡地位以及妇女的年龄，报告与最近进行过巴氏涂片检查的关联。方法：将各省的健康卡号和细胞学登记联系起来，以确定大陆新斯科舍省和布雷顿角妇女的筛查状况。邮政编码被链接到人口普查列举地区，然后与加拿大统计局的人口普查数据相联系，为每个妇女创建基于社区的文化措施。结果：新斯科舍省大陆的妇女更有可能最近进行巴氏涂片检查(优势比(OR)=1.36；95%可信区间(CI)：1.33-1.39)。生活在低收入(OR=1.19；CI：1.15-1.22)、原住民(OR=1.60，CI：1.46-1.76)、混合黑人(OR=1.25；CI：1.19-1.30)和农村(OR=1.09；CI：1.07-1.11)社区的女性和年龄较大的女性最近发生巴氏涂片的可能性较小。据报道，在美国和其他地方，巴氏筛查状况与低收入、农村居住地、土著和黑人遗产妇女之间的联系是基于个人的方法。我们的发现展示了一种方法，提供了一种测量种族和语言的方法，应该被考虑用于加拿大对服务利用、疾病状况和幸福感的研究。
Background: Pap smear screening is effective in reducing the incidence of cervical cancer. However, some subgroups of women are less likely to be screened than others. Since Canadian provincial health databases do not contain data fields identifying ethnicity or language, analyses employing these variables are typically not available. This paper overcomes this problem by using community- rather than person-based measures. Associations with having had a recent Pap smear are reported by community income, language, ethnic group, and urban/rural status, as well as the woman's age.Methods: The provincial Health Card Number and Cytology Registries were linked to ascertain the screening status of women in mainland Nova Scotia and Cape Breton. Postal codes were linked to census enumeration areas and then to Statistics Canada census data to create community-based cultural measures for each woman.Results: Women in mainland Nova Scotia were more likely to have had a recent Pap smear (Odds Ratio (OR)=1.36; 95% Confidence Interval (CI):1.33-1.39). Women living in low income (OR=1.19;CI:1.15-1.22), Aboriginal (OR=1.60,CI:1.46-1.76), mixed Black (OR=1.25;CI:1.19-1.30) and rural (OR=1.09;CI:1.07-1.11) communities and who were older were less likely to have had a recent Pap smear.Discussion: These findings were not unexpected. In the United States and elsewhere, associations between Pap screening status and women with low income, rural residence, Aboriginal and Black heritage have been reported using person-based methods. Our findings demonstrate a method of providing measures of ethnicity and language that should be considered for use in Canadian studies of service utilization, disease status, and well-being.