Spaczyński Marek, Nowak-Markwitz Ewa, Januszek-Michalecka Lucyna, Karowicz-Bilińska Agata
Klinka Onkologii Ginekologicznej Katedry Ginekologii, Połoznictwa i ginekologii Onkologicznej, Uniwersytet Medyczny, Poznań.
Ginekol Pol. 2009 Nov;80(11):833-8.
The Aim. Early diagnosis and screening are of vital importance in Poland because of high morbidity and mortality cervical cancer statistics. Polish cervical cancer screening programme is based on personal invitations which are sent to women aged from 25 to 59 every three years. The aim of the study was to assess socioeconomic conditions of the women who decided to accept or refuse that invitation.
The data was collected from questionnaires filled in by 1625 women (age: 25-59) who sought medical help from gynecologists in Poland. The questions included: age, place of living, education, marital status, children, reaction to the invitation acceptance and its reasons. Social profiles of women, both participating or not in screening, were characterized. Reasons for refusing the invite were analyzed. Data regarding the amount of PAP smear collected, number of practices cooperating with screening programme and invitation responses were obtained from SIMP. Statistical techniques for correspondence analyses was used in the study.
1261 respondents (77.5%) had PAP smear, 894 women received a personal invitation for screening and 38% of them ignored it. In Poland 55,467 women (5.5%) responded to the personal invitation (2009) and the number was independent of the number of cooperating practices (p=0.0001). Women from rural areas do not participate in the screening programme comparing to city dwellers (15.2% vs. 8%), single, unmarried and widows comparing with married and divorced (25% vs. 5%), and low-educated women in comparison to high-educated (20% vs. 6%). Lack of time (24%), dislike for seeing an unknown physician (23%) and the examination itself (15%) constitute the main reasons for the refusal. Women from villages and low-educated ones comprise the group not participating in screening. High-educated women undergo screening mainly in private medical institutions (38%).
Personal invitations for Pap smear examination constitute an ineffective method of increasing participation. The effectiveness of cervical cancer prophylaxis depends on medical education and at random access to medical care. Information campaign should be mainly directed at rural areas and among less educated people. The screening programme management should make sure women have easy access to a gynecologist by steadily increasing the number of cooperating medical practices.
由于宫颈癌的高发病率和死亡率统计数据，早期诊断和筛查在波兰至关重要。波兰的宫颈癌筛查计划基于每隔三年向25至59岁女性发出的个人邀请。本研究的目的是评估决定接受或拒绝该邀请的女性的社会经济状况。
数据收集自1625名（年龄25 - 59岁）在波兰向妇科医生寻求医疗帮助的女性填写的问卷。问题包括：年龄、居住地点、教育程度、婚姻状况、子女情况、对接受邀请的反应及其原因。对参与或未参与筛查的女性的社会概况进行了描述。分析了拒绝邀请的原因。关于收集的巴氏涂片数量、与筛查计划合作的医疗机构数量以及邀请回复的数据来自SIMP。本研究使用了对应分析的统计技术。
1261名受访者（77.5%）进行了巴氏涂片检查，894名女性收到了个人筛查邀请，其中38%的人忽略了该邀请。在波兰，55467名女性（5.5%）回复了个人邀请（2009年），且该数字与合作医疗机构的数量无关（p = 0.0001）。与城市居民相比，农村地区的女性不参与筛查计划（15.2%对8%），单身、未婚和丧偶女性与已婚和离异女性相比（25%对5%），以及低学历女性与高学历女性相比（20%对6%）。缺乏时间（24%）、不喜欢看陌生医生（23%）以及检查本身（15%）是拒绝的主要原因。来自农村和低学历的女性构成了不参与筛查的群体。高学历女性主要在私立医疗机构接受筛查（38%）。
个人邀请进行巴氏涂片检查是提高参与度的无效方法。宫颈癌预防的有效性取决于医学教育和随机获得医疗服务的机会。宣传活动应主要针对农村地区和受教育程度较低的人群。筛查计划管理部门应通过稳步增加合作医疗机构的数量，确保女性能够方便地看妇科医生。
