Doescher Mark P, Jackson J Elizabeth
Department of Family Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA.
J Public Health Manag Pract. 2009 May-Jun;15(3):200-9. doi: 10.1097/PHH.0b013e3181a117da.
The objective of this study was to assess rural-urban differences in mammography and Papanicolaou (Pap) smear screening.
Data from the Behavioral Risk Factor Surveillance System (1994-2000, 2002, 2004) were used to examine trends in these two tests by rural-urban residence location.
In 2004, 70.8 percent of rural and 75.7 percent of urban respondents had received timely mammography; this difference remained significant in adjusted analyses and was greatest for women in remote rural locations. Although overall participation in mammography increased over time, a persistent rural-urban gap was identified. In contrast, in 2004, while 83.1 percent of rural and 86.1 percent of urban respondents had received a timely Pap test, the adjusted difference was not significant and Pap testing did not improve over time. Advanced age and low socioeconomic status were associated with a lack of screening.
Over an 11-year interval, mammography screening improved nationally, but women living in rural locations remained less likely than their urban counterparts to receive this test. However, no secular improvement in Pap testing was found, and no significant rural-urban differences were observed.
Interventions to improve breast cancer screening are needed for rural women. Such efforts should target older women and those with low socioeconomic status.
本研究的目的是评估城乡在乳房X光检查和巴氏涂片筛查方面的差异。
使用行为危险因素监测系统（1994 - 2000年、2002年、2004年）的数据，按城乡居住地点来研究这两项检查的趋势。
2004年，70.8%的农村受访者和75.7%的城市受访者接受了及时的乳房X光检查；在调整分析中，这种差异仍然显著，且在偏远农村地区的女性中差异最大。尽管随着时间推移，乳房X光检查的总体参与率有所提高，但城乡差距依然存在。相比之下，2004年，83.1%的农村受访者和86.1%的城市受访者接受了及时的巴氏试验，调整后的差异不显著，且巴氏试验随时间没有改善。高龄和低社会经济地位与缺乏筛查相关。
在11年的时间里，乳房X光检查在全国范围内有所改善，但农村女性接受这项检查的可能性仍低于城市女性。然而，未发现巴氏试验有长期改善，也未观察到显著的城乡差异。
需要针对农村女性采取干预措施以改善乳腺癌筛查。这些努力应针对老年女性和社会经济地位低的女性。
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