Cervical cancer screening among US women: analyses of the 2000 National Health Interview Survey
Cervical cancer screening among US women: analyses of the 2000 National Health Interview Survey
复制标题
DOI：
10.1016/j.ypmed.2004.03.035
复制
发表时间：
2004-08-01
影响因子：
5.1
通讯作者：
Breen, N
中科院分区：
文献类型：
--
作者：
Hewitt, M;Devesa, SS;Breen, N
背景资料。在美国，宫颈癌筛查在所有妇女群体中都没有得到充分利用，特别是无法获得医疗保健的妇女和老年妇女。使用2000年全国健康访谈调查(NHIS)的数据，对18岁及以上的美国女性进行了Papanicolaou(Pap)测试。在没有做过子宫切除术的妇女(n=13,745)中，83%的人报告在过去3年内做过巴氏试验。Logistic回归分析表明，在过去一年中没有接触过初级保健提供者的妇女报告最近的巴氏试验的可能性很小。与较低的巴氏试验使用率相关的其他特征包括缺乏通常的照顾来源、家庭收入低、教育程度低以及未婚。在65岁以下的妇女中，没有医疗保险与较低的巴氏试验使用率有关。尽管保险覆盖率较高，但65岁及以上的人使用情况较低。最近的巴氏试验在非裔美国女性中的比率较高。普及保险覆盖范围和通常的医疗保健来源的政策可能会增加巴氏试验的使用。还需要卫生系统的改变，例如自动提醒，以帮助卫生保健提供者实施适当的筛查。需要医生的重新努力和有针对性的公共卫生信息，以改善在没有事先进行巴氏试验的情况下对老年妇女的筛查。(C)2004年癌症预防研究所和爱思唯尔公司。保留所有权利。
Background. Cervical cancer screening is not fully utilized among all groups of women in the United States, especially women without access to health care and older women.Methods. Papanicolaou (Pap) test use among U.S. women age 18 and older is examined using data from the 2000 National Health Interview Survey (NHIS).Results. Among women who had not had a hysterectomy (n = 13,745), 83% reported having had a Pap test within the past 3 years. Logistic regression analyses showed that women with no contact with a primary care provider in the past year were very unlikely to have reported a recent Pap test. Other characteristics associated with lower rates of Pap test use included lacking a usual source of care, low family income, low educational attainment, and being unmarried. Having no health insurance coverage was associated with lower Pap test use among women under 65. Despite higher insurance coverage, being age 65 and older was associated with low use. Rates of recent Pap test were higher among African-American women.Conclusions. Policies to generalize insurance coverage and a usual source of health care would likely increase use of Pap testing. Also needed are health system changes such as automated reminders to assist health care providers implement appropriate screening. Renewed efforts by physicians and targeted public health messages are needed to improve screening among older women without a prior Pap test. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.