De Alba Israel, Sweningson Jamie M
Department of Medicine, Division of General Internal Medicine and Primary Care, University of California, Irvine, CA 92697-5800, USA.
Cancer Detect Prev. 2006;30(3):292-6. doi: 10.1016/j.cdp.2006.05.003. Epub 2006 Jul 17.
Hispanics have one of the highest incidence rates of cervical cancer. Physician recommendation is one of the most important cues to cancer screening; however, low English proficiency among Hispanics may hinder health providers' recommendation of Pap smears.
Analysis of data from the 2000 National Health Interview Survey. All Hispanic women, age > or =18, without a Pap smear in the past 3 years or ever and who visited a health care provider in the past year were included. The main outcome was receipt of Pap smear recommendation by a health care provider.
A total of 314 Hispanic women were included in the analysis, 44.9% were highly English proficient. Only 7.7% of low English proficient Hispanics not up-to-date in cancer screening reported a recommendation for a Pap smear as compared to 14.3% of highly proficient Hispanics. After adjusting for sociodemographics and health access and utilization factors, highly English proficient Hispanics were more than two times as likely to report receiving a recommendation for a Pap smear as compared to the less proficient (aOR 2.2, 95% CI 1.1-4.5).
Low English language proficiency is a barrier to receive a recommendation for Pap smear among Hispanic women not up-to-date with cervical cancer screening. Further research is needed to explore specific mechanisms responsible for the low recommendation rates and to assess the impact of interpreters or Spanish-speaking providers on Pap smear recommendation rates.
西班牙裔女性的宫颈癌发病率位居前列。医生建议是癌症筛查最重要的提示之一；然而，西班牙裔人群英语水平较低可能会妨碍医疗服务提供者推荐巴氏涂片检查。
对2000年全国健康访谈调查的数据进行分析。纳入所有年龄≥18岁、在过去3年或既往从未进行过巴氏涂片检查且在过去一年中就诊过医疗服务提供者的西班牙裔女性。主要结局是医疗服务提供者是否推荐进行巴氏涂片检查。
共有314名西班牙裔女性纳入分析，44.9%英语水平高。在未及时进行癌症筛查的英语水平低的西班牙裔女性中，只有7.7%报告有巴氏涂片检查的推荐，而英语水平高的西班牙裔女性这一比例为14.3%。在对社会人口统计学以及医疗可及性和利用因素进行调整后，与英语水平较低的西班牙裔女性相比，英语水平高的西班牙裔女性报告收到巴氏涂片检查推荐的可能性高出两倍多（调整后的比值比为2.2，95%置信区间为1.1 - 4.5）。
对于未及时进行宫颈癌筛查的西班牙裔女性，英语水平低是获得巴氏涂片检查推荐的一个障碍。需要进一步研究以探索导致推荐率低的具体机制，并评估口译员或讲西班牙语的医疗服务提供者对巴氏涂片检查推荐率的影响。
