Timeliness and follow-up patterns of cervical cancer detection in a cohort of medically underserved California women.
Timeliness and follow-up patterns of cervical cancer detection in a cohort of medically underserved California women.
复制标题
在医疗服务不足的加州妇女群体中宫颈癌检测的及时性和随访模式。
DOI：
10.1007/s10552-009-9473-1
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Howell,LydiaPleotis
中科院分区：
文献类型：
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作者：
Tabnak,Farzaneh;Müller,Hans-Georg;Wang,Jane-Ling;Zhang,Weihong;Howell,LydiaPleotis
本研究探讨了在一个为缺乏医疗服务的加州妇女提供宫颈癌检测服务的项目中，与巴氏试验后及时随访相关的因素。使用COX比例风险回归来确定诊断或治疗时间延迟的妇女亚组。用Logistic回归分析评估计划进行最终诊断和治疗的概率。对失访妇女的人口学和临床特征进行检查。结果从筛查到最终诊断的时间因年龄组、种族/民族和巴氏试验结果而不同。种族/民族和年龄与是否安排治疗有关。虽然在计划最终诊断的患者中失去随访与某些患者的特征有关，但在计划治疗的患者中没有发现这种关联。结论患者的人口学特征决定了最终诊断和治疗的计划几率以及从筛查到最终诊断的随访的及时性。调查结果表明，如果不考虑种族/族裔差异和需求，就不可能实现缩小健康差距和以成本效益高的方式检测和治疗癌前疾病以预防宫颈癌的双重目标。
IntroductionThis study examines factors associated with timely follow-up after Pap test in a program providing cervical cancer detection services to medically underserved California women.MethodsData between 01 January 1992 and 30 June 2007 were analyzed. Cox proportional hazard regression was used to identify subgroups of women with delayed time to diagnosis or treatment scheduling. The probability of being scheduled for final diagnosis and treatment was assessed using logistic regression analysis. Demographic and clinical characteristics of the women lost to follow up were examined.ResultsTime from screening to final diagnosis scheduling differed according to age group, race/ethnicity, and Pap test result. Race/ethnicity and age were associated with whether treatment was scheduled or not. While loss to follow up among those scheduled for final diagnosis was associated with certain patients’ characteristics, no such association was found among those who were scheduled for treatment.ConclusionsPatient’s demographic characteristics determine the odds of being scheduled for final diagnosis and treatment as well as timeliness of follow-up from screening to final diagnosis. Findings suggest that the dual goal of reducing health disparities and cost-effective detection and treatment of precancerous disease to prevent cervical cancers cannot be achieved without consideration of racial/ethnic differences and needs.