Cervical cancer screening among women in metropolitan areas of the United States by individual-level and area-based measures of socioeconomic status, 2000 to 2002
Cervical cancer screening among women in metropolitan areas of the United States by individual-level and area-based measures of socioeconomic status, 2000 to 2002
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DOI：
10.1158/1055-9965.epi-05-0914
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发表时间：
2006-11-01
影响因子：
3.8
通讯作者：
Ekwueme, Donatus U.
中科院分区：
文献类型：
--
作者：
Coughlin, Steven S.;King, Jessica;Ekwueme, Donatus U.
背景资料：很少有研究探讨居住在大都市地区的妇女之间的癌症筛查与个人水平和基于地区的社会经济地位（SES）的措施。为了了解更多，我们检查了居住在大都市地区的妇女自我报告的巴氏涂片（Pap）检测率与SES的个人水平测量值之间的关系（家庭收入和教育）以及基于地区的社会经济状况衡量标准（生活贫困的居民百分比、教育程度低的居民百分比和工人阶级百分比）。数据来自2000年至2002年期间通过电话采访的妇女，作为行为风险因素监测系统的一部分。自我报告的居住县被用来将受访者归类为大都市统计区的居民。这项分析只包括2000年居住在人口超过150万的35个大都市统计区的联邦调查局答卷人。分析仅限于年龄≥ 18岁且无子宫切除史的女性（n = 49，231）。基于地区的措施，社会经济地位，获得了使用县级信息从2000年美国人口普查。结果：只有75.4% [95%置信区间（95%CI），73.8-77.1%]的3,947名妇女年龄≥ 18岁的家庭收入= 50000美元。总体而言，77.5%（95% CI，75.7-79.3%）的未受过高中教育的妇女接受过巴氏试验，而91.7%（91.0-92.3%）的大学毕业生。在多变量分析中，我们还发现教育水平与巴氏试验率呈正相关，特别是在妇女居住的地区，相对较低比例的居民有一个低的教育水平（P < 0.0001）。结论：个人层面的措施，SES可以修改县级措施的SES。通过收入、教育程度和其他因素来分析癌症筛查率，可能有助于卫生官员更好地将有限的资源用于最需要的领域。
Background: Few studies have examined cancer screening among women residing in metropolitan areas in relation to both individual-level and area-based measures of socioeconomic status (SES). To learn more, we examined self-reported rates of Papanicolaou (Pap) testing among women living in metropolitan areas in relation to individual-level measures of SES (household income and education), and area-based measures of SES (percentage of residents living in poverty, percentage with low education, and percentage working class).Methods: Data were obtained from women who were interviewed by telephone during 2000 and 2002 as part of the Behavioral Risk Factor Surveillance System (BRFSS). Self-reported county of residence was used to classify respondents as residents of metropolitan statistical areas. Only BRFSS respondents who resided in 35 metropolitan statistical areas with a population of >= 1.5 million in 2000 were included in this analysis. Analyses were limited to women ages >= 18 years with no history of hysterectomy (n = 49,231). Area-based measures of SES were obtained by using county-level information from the 2000 U.S. Census.Results: Only 75.4% [95% confidence interval (95% CI), 73.8-77.1%] of 3,947 women ages >= 18 years who had a reported household income of =$50,000. Overall, 77.5% (95% CI, 75.7-79.3%) of women without a high school education had received a Pap test compared with 91.7% (91.0-92.3%) of college graduates. In multivariate analysis, we also found education level to be positively associated with Pap testing rates, especially among women residing in areas where a relatively low percentage of residents had a low education level (P < 0.0001).Conclusions: Individual-level measures of SES may be modified by county-level measures of SES. Analyses of cancer screening rates by measures of income, educational attainment, and other factors may help health officials to better direct their finite resources to areas of greatest need.