Eggleston Katherine S, Coker Ann L, Das Irene Prabhu, Cordray Suzanne T, Luchok Kathryn J
University of Texas Health Science Center, School of Public Health, Houston, Texas 77025, USA.
J Womens Health (Larchmt). 2007 Apr;16(3):311-30. doi: 10.1089/jwh.2006.0161.
Approximately 4000 women annually will die from preventable and treatable cervical cancer. Failure to adhere to follow-up recommendations after an abnormal Pap test can lead to development of cervical cancer. This paper summarizes the body of literature on adherence to follow-up after an abnormal Pap test in order to facilitate development of interventions to decrease morbidity and mortality due to cervical cancer.
We conducted a comprehensive search of published literature addressing risk factors for adherence or interventions to improve adherence following an abnormal Pap test as the outcome. We included peer-reviewed original research conducted in the United States from 1990 to 2005.
Fourteen analytical and twelve experimental studies that met our criteria were reviewed. Lesion severity and health beliefs were consistently associated with adherence rates. Communication interventions, including telephone reminders, counseling, and educational sessions, increased follow-up compliance across intervention studies. Inconsistent evidence for associations among race, income, and age were found.
Further research is needed to reinforce current studies addressing health beliefs and social support. Interventions that focus on the interplay among psychological, educational, and communication barriers are necessary. These interventions should be adapted and applied across various racial/ethnic and socioeconomic groups to reach all women with a high-risk profile for invasive cervical cancer.
每年约有4000名女性会死于可预防和可治疗的宫颈癌。巴氏试验结果异常后未遵循后续建议可能会导致宫颈癌的发生。本文总结了关于巴氏试验结果异常后遵循后续建议的文献，以促进制定干预措施，降低宫颈癌的发病率和死亡率。
我们对已发表的文献进行了全面检索，这些文献以巴氏试验结果异常后遵循后续建议的风险因素或改善遵循情况的干预措施为研究结果。我们纳入了1990年至2005年在美国进行的同行评审的原创研究。
对符合我们标准的14项分析性研究和12项实验性研究进行了综述。病变严重程度和健康观念一直与遵循率相关。包括电话提醒、咨询和教育课程在内的沟通干预措施，在各项干预研究中均提高了后续随访的依从性。在种族、收入和年龄之间的关联方面，证据并不一致。
需要进一步开展研究，以加强目前针对健康观念和社会支持的研究。有必要采取侧重于心理、教育和沟通障碍之间相互作用的干预措施。这些干预措施应进行调整并应用于不同的种族/族裔和社会经济群体，以覆盖所有患浸润性宫颈癌风险较高的女性。
