Differences in cervical cancer screening and follow-up for black and white women in the United States
Differences in cervical cancer screening and follow-up for black and white women in the United States
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DOI：
10.1016/j.ygyno.2020.11.027
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发表时间：
2021-01-23
影响因子：
4.7
通讯作者：
Leach, Richard
中科院分区：
文献类型：
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作者：
Ford, Sabrina;Tarraf, Wassim;Leach, Richard
客观的。研究非西班牙裔黑人（黑人）和非西班牙裔白人（白人）女性巴氏试验异常后筛查依从性和随访的差异。方法。一项观察性队列研究，使用 2010 年全国健康访谈调查癌症模块来检查 18 岁或以上未接受子宫切除术的黑人和白人女性的 HPV 知识、筛查行为以及异常巴氏试验的后续情况。我们拟合逻辑回归模型来检查种族和主要结果变量之间的关联，包括：HPV意识、过去三年的巴氏涂片检查、提供者推荐的巴氏涂片检查、收到的巴氏涂片检查结果、有异常的巴氏涂片检查、建议的随访以及遵守随访建议。结果。分析 7509 名女性的数据，黑人女性在以下方面的优势比 [OR] 较低：1) HPV 知晓率（71% vs 83%；OR = 0.42；95% CI = 0.36-0.49）； 2) 建议报告巴氏涂片筛查（59% vs 64%；OR = 0.76；95% CI = 0.66-0.88），3) 确认收到巴氏涂片结果（92% vs 94%；OR = 0.64；95% CI = 0.49-0.83）。协变量调整后，组间差异仍然存在。在调整后的模型中，黑人女性报告近期进行巴氏筛查的几率较高（84% vs 77%；OR = 1.7；95% CI = 1.42-2.03），但报告异常检测后接受后续建议的几率较低（78% vs 87%；OR = 0.54；95% CI = 0.31-0.95）。结论。黑人女性的宫颈癌筛查依从性较高，但被告知巴氏涂片检查异常并联系后续治疗的比率较低。我们建议采用多层次的方法，为患者、医生、接受培训的临床医生和诊所级别的辅助人员提供适合文化的教育和沟通。(c) 2020 Elsevier Inc. 保留所有权利。
Objective. To study differences in screening adherence and follow-up after an abnormal Pap test in Non Hispanic Black (Black) and Non-Hispanic White (White) women.Methods. An observational cohort study using 2010 National Health Interview Survey cancer module to examine HPV knowledge, screening behavior, and follow-up to abnormal Pap test in Black and White women 18 years of age or older without a hysterectomy. We fit logistic regression models to examine associations between race and primary outcome variables including: HPV awareness, Pap test in the last three years, provider recommended Pap test, received Pap test results, had an abnormal Pap test, recommended follow-up, and adhered to the recommendation for follow-up.Results. Analyzing data for 7509 women, Black women had lower odds ratios [OR] for: 1) HPV awareness (71% vs 83%; OR = 0.42; 95% CI = 0.36-0.49); 2) reporting Pap screening was recommended (59% vs 64%; OR = 0.76; 95% CI = 0.66-0.88), and 3) acknowledging receipt of Pap results (92% vs 94%; OR = 0.64; 95% CI = 0.49-0.83). Group differences persisted after covariates adjustment. In adjusted models, Black women had higher odds of reporting recent Pap screening (84% vs 77%; OR = 1.7; 95% CI = 1.42-2.03), but reported lower odds of receiving a follow-up recommendation subsequent to abnormal test (78% vs 87%; OR = 0.54; 95% CI = 0.31-0.95).Conclusion. Black women reported higher cervical cancer screening adherence but lower rates of being informed of an abnormal Pap test and contacted for follow-up treatment. We recommend a multilevel approach to deliver culturally appropriate education and communication for patients, physicians, clinicians in training, and clinic level ancillary staff.(c) 2020 Elsevier Inc. All rights reserved.