Social and cultural barriers to Papanicolaou test screening in an urban population
Social and cultural barriers to Papanicolaou test screening in an urban population
复制标题
DOI：
10.1097/01.aog.0000143881.53058.81
复制
发表时间：
2004-12-01
影响因子：
7.2
通讯作者：
Massad, S
中科院分区：
文献类型：
--
作者：
Behbakht, K;Lynch, A;Massad, S
目的：了解宫颈癌妇女的筛查行为、对癌症及其治疗的态度和信念。方法：在2000年8月至2002年7月期间，对148名连续患浸润性宫颈癌的妇女进行了筛查障碍调查。妇女被送到3家城市医院的门诊、急诊科或住院部。研究人员确定了两组女性：否认做过巴氏试验的女性和回忆过去做过巴氏试验的女性。采用t检验、chi(2)检验和二元逻辑回归对反应进行比较。结果：146名（99%）受访者主要是非裔美国人（50%）或西班牙裔（27%）。36名（25%）妇女报告没有事先筛查。从未接受筛查的女性更有可能是西班牙裔（比值比[OR] 3.0,95%可信区间[CI] 1.4-6.7）、新移民（比值比[OR] 5.7, 95% CI 2.0 -16）、受教育程度较低（比值比[OR] 3.6, 95% CI 1.6- 8.0）和未投保（比值比[OR] 3.9, 95% CI 1.6-9.7）。他们更有可能缺乏家庭支持（调整后的OR为3.5,95% CI为1.1-11），并且对自己患宫颈癌的风险缺乏了解（调整后的OR为2.6,95% CI为1.1-6.4）。未接受筛查的女性表现出宿命的态度，认为癌症是厄运（调整后的OR为2.6,95% CI 1.0-6.9），不想知道自己得了癌症（调整后的OR为3.0,95% CI 1.0 -9.4）。结论：我们已经确定了阻碍城市宫颈癌患者进行巴氏试验筛查的因素和信念。进一步的研究应该评估文化、认知和经济障碍对巴氏试验依从性的影响。(C) 2004年由美国妇产科医师学会出版。
OBJECTIVE: To define screening behaviors, attitudes, and beliefs regarding cancer and its treatment among women with cervical cancer.METHODS: Between August 2000 and July 2002,148 consecutive women with invasive cervical cancer were queried about barriers to screening. Women presented to outpatient clinics, emergency departments, or inpatient units of 3 urban hospitals. Two groups of women were identified: those who denied having had a Papanicolaou (Pap) test and those who had recalled having Pap test in the past. Responses were compared using t tests, chi(2) tests, and binary logistic regression.RESULTS: The 146 (99%) respondents were predominantly African Americans (50%) or Hispanic (27%). Thirty-six (25%) women reported no prior screening. Women never screened were significantly more likely to be Hispanic (odds ratio [OR] 3.0,95% confidence interval [CI] 1.4-6.7), recent immigrants (OR 5.7, 95% CI 2.0 -16), less educated (OR 3.6, 95% CI 1.6 - 8.0), and uninsured (OR 3.9, 95% CI 1.6-9.7). They Were more likely to lack family support (adjusted OR 3.5, 95% CI 1.1-11) and lack knowledge about their risk for cervical cancer (adjusted OR 2.6, 95% CI 1.1-6.4). Unscreened women displayed fatalistic attitudes, believing cancer is bad luck (adjusted OR 2.6, 95% CI 1.0-6.9) and not wanting to know they had cancer (adjusted OR 3.0, 95% CI 1.0 -9.4).CONCLUSION: We have identified factors and beliefs that are barriers to Pap test screening in urban cervical cancer patients. Further studies should evaluate effects of addressing cultural, cognitive, and financial barriers on Pap test compliance. (C) 2004 by The American College of Obstetricians and Gynecologists.