Wellensiek N, Moodley M, Moodley J, Nkwanyana N
Department of Obstetrics and Gynaecology and MRC/UN Pregnancy Hypertension Research Unit, Nelson R Mandela School of Medicine, University of Natal, Congella 4013, South Africa.
Int J Gynecol Cancer. 2002 Jul-Aug;12(4):376-82. doi: 10.1046/j.1525-1438.2002.01114.x.
The value of screening for cervical cancer has been proven. Such screening in developed countries has achieved a decrease in incidence and mortality by about 80%. Although screening facilities are available in certain parts of developing countries, the incidence of cervical cancer remains very high and many patients present with late stage disease. The study was performed among women from different socioeconomic circumstances (low, middle, and upper social/financial backgrounds). The assessment was performed by means of a questionnaire. The majority of patients from lower socio-economic circumstances with multiple risk factors were not aware of cervical screening or facilities available for this purpose. However, in spite of knowledge of cervical screening and the availability of such services, the majority of women (87%) from higher social and educational backgrounds did not undergo cervical screening. Most patients resided within a 12-kilometer radius of a facility that either provided or could potentially provide screening. Although some patients (36.7%) had had a screening test performed at some time in the past, only 27.3% of patients reported having had a Pap test. This was due to failure on the part of the healthcare giver to disseminate information to the patient regarding the reason and value of cervical screening. Among women from higher socioeconomic groups, the level of education was better and knowledge of the Pap test was not age-dependent. We conclude that the mere provision of a cervical cancer screening service is not sufficient to ensure successful uptake since screening is a multifaceted entity. Improvement of socioeconomic and educational circumstances should improve the uptake of a screening program only if the healthcare giver provides appropriate information to the patient and the patient takes the initiative to avail themselves of such screening.
宫颈癌筛查的价值已得到证实。在发达国家，此类筛查已使发病率和死亡率降低了约80%。尽管发展中国家的某些地区具备筛查设施，但宫颈癌的发病率仍然很高，许多患者就诊时已处于疾病晚期。该研究针对来自不同社会经济背景（低、中、高社会/经济背景）的女性进行。评估通过问卷调查的方式进行。大多数来自社会经济背景较低且存在多种风险因素的患者并不知晓宫颈癌筛查或为此目的可利用的设施。然而，尽管知晓宫颈癌筛查且有此类服务，但大多数来自较高社会和教育背景的女性（87%）并未接受宫颈癌筛查。大多数患者居住在提供或可能提供筛查的机构半径12公里范围内。尽管一些患者（36.7%）过去曾在某个时间进行过筛查测试，但只有27.3%的患者报告进行过巴氏试验。这是由于医疗服务提供者未能向患者传播有关宫颈癌筛查的原因和价值的信息。在社会经济地位较高的女性群体中，教育水平较高，对巴氏试验的了解与年龄无关。我们得出结论，仅仅提供宫颈癌筛查服务不足以确保成功参与，因为筛查是一个多方面的事情。只有当医疗服务提供者向患者提供适当信息且患者主动利用此类筛查时，社会经济和教育状况的改善才应会提高筛查项目的参与率。
