Ross Joseph S, Nuñez-Smith Marcella, Forsyth Beverly A, Rosenbaum Julie R
Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, Bronx, NY, USA.
BMC Public Health. 2008 Oct 30;8:378. doi: 10.1186/1471-2458-8-378.
Racial and ethnic disparities in cervical cancer screening have been attributed to socioeconomic, insurance, and cultural differences. Our objective was to explore racial and ethnic differences in adherence to cervical cancer screening recommendations among female post-graduate physicians.
We conducted a cross-sectional survey at one university hospital among a convenience sample of 204 female post-graduate physicians (52% of all potential participants), examining adherence to United States Preventive Services Task Force cervical cancer screening recommendations, perception of adherence to recommendations, and barriers to obtaining care.
Overall, 83% of women were adherent to screening recommendations and 84% accurately perceived adherence or non-adherence. Women who self-identified as Asian were significantly less adherent when compared with women who self-identified as white (69% vs. 87%; Relative Risk [RR]=0.79, 95% Confidence Interval [CI], 0.64-0.97; P<0.01). Women who self-identified as East Indian were significantly less likely to accurately perceive adherence or non-adherence when compared to women who self-identified as white (64% vs. 88%; RR=0.73, 95% CI, 0.49-1.09, P=0.04). Women who self-identified as Asian were significantly more likely to report any barrier to obtaining care when compared with women who self-identified as white (60% vs. 35%; RR=1.75, 95% CI, 1.24-2.47; P=0.001) and there was a non-significant tendency toward women who self-identified as East Indian being more likely to report any barrier to obtaining care when compared with women who self-identified as white (60% vs. 34%; RR=1.74, 95% CI, 1.06-2.83; P=0.06).
Among a small group of insured, highly-educated physicians who have access to health care, we found racial and ethnic differences in adherence to cervical cancer screening recommendations, suggesting that culture may play a role in cervical cancer screening.
宫颈癌筛查中的种族和民族差异归因于社会经济、保险和文化差异。我们的目的是探讨女性研究生医生在遵循宫颈癌筛查建议方面的种族和民族差异。
我们在一家大学医院对204名女性研究生医生(占所有潜在参与者的52%)的便利样本进行了横断面调查,检查对美国预防服务工作组宫颈癌筛查建议的遵循情况、对建议遵循情况的认知以及获得医疗服务的障碍。
总体而言,83%的女性遵循筛查建议,84%准确感知到遵循或未遵循情况。自我认定为亚洲人的女性与自我认定为白人的女性相比,遵循率显著较低(69%对87%;相对风险[RR]=0.79,95%置信区间[CI],0.64 - 0.97;P<0.01)。自我认定为东印度人的女性与自我认定为白人的女性相比,准确感知遵循或未遵循情况的可能性显著较低(64%对88%;RR=0.73,95%CI,0.49 - 1.09,P=0.04)。自我认定为亚洲人的女性与自我认定为白人的女性相比,报告获得医疗服务存在任何障碍的可能性显著更高(60%对35%;RR=1.75,95%CI,1.24 - 2.47;P=0.001),并且自我认定为东印度人的女性与自我认定为白人的女性相比,报告获得医疗服务存在任何障碍的可能性有不显著的增加趋势(60%对34%;RR=1.74,95%CI,1.06 - 2.83;P=0.06)。
在一小群有保险、受过高等教育且能获得医疗服务的医生中,我们发现了在遵循宫颈癌筛查建议方面的种族和民族差异,这表明文化可能在宫颈癌筛查中发挥作用。