Taylor Victoria M, Jackson J Carey, Tu Shin-ping, Yasui Yutaka, Schwartz Stephen M, Kuniyuki Alan, Acorda Elizabeth, Lin Kathy, Hislop Gregory
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98105, USA.
Cancer Detect Prev. 2002;26(2):139-45. doi: 10.1016/s0361-090x(02)00037-5.
Chinese women in North America have high rates of invasive cervical cancer and low levels of Papanicolaou (Pap) testing use. This study examined Pap testing barriers and facilitators among Chinese American women.
A community-based, in-person survey of Chinese women was conducted in Seattle, Washington during 1999. Four hundred and thirty-two women in the 20-79 years age-group were included in this analysis. The main outcome measures were a history of at least one previous Pap smear and Pap testing within the last 2 years.
Nineteen percent of the respondents had never received cervical cancer screening and 36% had not been screened in the previous 2 years. Eight characteristics were independently associated with a history of at least one Pap smear: being married, thinking Pap testing is necessary for sexually inactive women, lack of concerns about embarrassment or cancer being discovered, having received a physician or family recommendation, having obtained family planning services in North America, and having a regular provider. The following characteristics were independently associated with recent screening: thinking Pap testing is necessary for sexually inactive women, lack of concern about embarrassment, having received a physician recommendation, having obtained obstetric services in North America, and having a regular provider.
Pap testing levels among the study respondents were well below the National Cancer Institute's Year 2000 goals. The findings suggest that cervical cancer control interventions for Chinese are more likely to be effective if they are multifaceted.
北美华裔女性浸润性宫颈癌发病率较高,而巴氏涂片检查使用率较低。本研究调查了华裔美国女性进行巴氏涂片检查的障碍和促进因素。
1999年在华盛顿州西雅图市对华裔女性进行了一项基于社区的面对面调查。本分析纳入了432名年龄在20 - 79岁之间的女性。主要结局指标为至少有过一次巴氏涂片检查史以及过去两年内进行过巴氏涂片检查。
19%的受访者从未接受过宫颈癌筛查,36%的人在过去两年内未接受过筛查。有八个特征与至少有过一次巴氏涂片检查史独立相关:已婚、认为巴氏涂片检查对无性活动的女性有必要、不担心尴尬或被查出患有癌症、接受过医生或家人的推荐、在北美接受过计划生育服务以及有固定的医疗服务提供者。以下特征与近期筛查独立相关:认为巴氏涂片检查对无性活动的女性有必要、不担心尴尬、接受过医生推荐、在北美接受过产科服务以及有固定的医疗服务提供者。
研究受访者的巴氏涂片检查水平远低于美国国家癌症研究所2000年的目标。研究结果表明,如果针对华裔人群的宫颈癌控制干预措施具有多方面性,则更有可能有效。