Taylor Victoria M, Nguyen Tung T, Jackson J Carey, McPhee Stephen J
Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center (M3-B232), 1100 Fairview Avenue North, Seattle, WA 98109, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):2924-30. doi: 10.1158/1055-9965.EPI-08-0386.
Census data show that the U.S. Vietnamese population now exceeds 1,250,000. Cervical cancer among Vietnamese American women has been identified as an important health disparity. Available data indicate the cervical cancer disparity may be due to low Papanicolaou (Pap) testing rates rather than variations in human papillomavirus infection rates and/or types. The cervical cancer incidence rates among Vietnamese and non-Latina White women in California during 2000 to 2002 were 14.0 and 7.3 per 100,000, respectively. Only 70% of Vietnamese women who participated in the 2003 California Health Interview Survey reported a recent Pap smear compared with 84% of non-Latina White women. Higher levels of cervical cancer screening participation among Vietnamese women are strongly associated with current/previous marriage, having a usual source of care/doctor, and previous physician recommendation. Vietnamese language media campaigns and lay health worker intervention programs have been effective in increasing Pap smear use in Vietnamese American communities. Cervical cancer control programs for Vietnamese women should address knowledge deficits, enable women who are without a usual source of care to find a primary care doctor, and improve patient-provider communication by encouraging health-care providers to recommend Pap testing as well as by empowering women to ask for testing.
人口普查数据显示,美国越南裔人口现已超过125万。美籍越南裔女性的宫颈癌已被视为一项重大的健康差异问题。现有数据表明,宫颈癌差异可能是由于巴氏试验(Pap)检测率较低,而非人乳头瘤病毒感染率和/或类型的差异。2000年至2002年期间,加利福尼亚州越南裔和非拉丁裔白人女性的宫颈癌发病率分别为每10万人中有14.0例和7.3例。在参与2003年加利福尼亚州健康访谈调查的越南裔女性中,只有70%报告近期做过巴氏涂片检查,相比之下,非拉丁裔白人女性的这一比例为84%。越南裔女性中较高水平的宫颈癌筛查参与率与当前/以前结婚、有固定的医疗服务来源/医生以及以前有医生推荐密切相关。越南语媒体宣传活动和外行人健康工作者干预项目在增加美籍越南裔社区巴氏涂片检查的使用率方面已取得成效。针对越南裔女性的宫颈癌控制项目应解决知识欠缺问题,使没有固定医疗服务来源的女性能够找到初级保健医生,并通过鼓励医疗服务提供者推荐巴氏试验以及赋予女性要求进行检测的权力来改善医患沟通。