Persistent disparities of cervical cancer among American Indians/Alaska natives: Are we maximizing prevention tools?

Persistent disparities of cervical cancer among American Indians/Alaska natives: Are we maximizing prevention tools?
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美洲印第安人/阿拉斯加原住民之间宫颈癌的持续差异:我们是否最大限度地利用了预防工具?

DOI:
10.1016/j.ygyno.2022.11.007
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发表时间:
2023
影响因子:
4.7
通讯作者:
Tirumala,K
Tirumala,K
中科院分区:
医学2区
文献类型:
--
作者:
Bruegl,AS;Emerson,J;Tirumala,K

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美国印第安人/阿拉斯加原住民(AI/AN)妇女经历的宫颈癌发病率和死亡率的差异已经持续了几十年。巴氏涂片筛查和HPV疫苗接种是预防宫颈癌的有力工具。我们评估了这些工具的利用AI/AN生活在太平洋西北部(PNW)。MethodsThe印度卫生服务(IHS)国家数据仓库的EPI数据集市进行了分析,使用所有的医疗保健访问从2010年至2020年,从IHS,部落,和城市印度诊所在PNW。年龄在21-64岁的女性被纳入,如果她们在最近的临床遭遇的3年内进行了细胞学检查或在5年内进行了细胞学检查和HPV检测,则被认为是最新的巴氏涂片检查。计算了9-26岁人群的HPV疫苗接种率。HPV疫苗接种被认为是完整的,如果:两个疫苗之前收到的15岁或三个疫苗接种后,如果开始后15.FindingsCervical癌筛查率低于全国平均水平的73.5%之间的57.1% -65.0%。对年龄组的亚组分析表明,50-64岁年龄组的最新巴氏涂片筛查率大大降低。随着时间的推移,所有年龄组的男女HPV疫苗接种率都有所增加。然而,目前58.6%的疫苗接种率远低于“健康人民2030”的目标84.3%。解读宫颈癌筛查和HPV疫苗接种是预防和早期发现宫颈癌的基石。这些工具未得到充分利用,公共卫生工作可以加强,以改善宫颈癌的差距AI/AN women.FundingAuthor ASB:该项目的资金已通过罗伯特伍德约翰逊基金会哈罗德阿莫斯少数民族教师发展补助金和国家癌症研究所K 08指导临床科学家发展奖提供。
BackgroundCervical cancer incidence and mortality disparities experienced by American Indian/Alaska Native (AI/AN) women have persisted for decades. Pap smear screening and HPV vaccination are powerful tools to prevent cervical cancer. We evaluated the utilization of these tools among AI/ANs living in the Pacific Northwest (PNW).MethodsThe Indian Health Service (IHS) National Data Warehouse's Epi Data Mart was analyzed using all healthcare visits from 2010 to 2020 from IHS, Tribal, and Urban Indian clinics in the PNW. Women ages 21–64 were included and considered up-to-date on pap smears if they had either cytology within 3 years or cytology with HPV testing within 5 years of the most recent clinical encounter. HPV vaccination rates for both sexes were calculated for individuals ages 9–26. HPV vaccination was considered complete if: two vaccines were received prior to age 15 or after three vaccinations if initiated after age 15.FindingsCervical cancer screening rates are below the national average of 73.5% ranging between 57.1% - 65.0%. Sub-analysis of age groups shows substantially lower rates of up-to-date pap smear screening in the 50–64 age group. HPV vaccination rates have increased over time for both sexes across all age groups. However, the current vaccination rate of 58.6% is well below the Healthy People 2030 goal of 84.3%.InterpretationCervical cancer screening and HPV vaccination are the cornerstones of cervical cancer prevention and early detection. These tools are underutilized and public health efforts can be strengthened to improve cervical cancer disparities in AI/AN women.FundingAuthor ASB: Funding for this project has been provided through the Robert Wood Johnson Foundation Harold Amos Minority Faculty Development Grant and the National Cancer Institute K08 Mentored Clinical Scientist Development Award.
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