Eur J Cancer Prev. 2010 May;19(3):239-45. doi: 10.1097/CEJ.0b013e3283372125.
Gynecological cancers are an important cause of morbidity and mortality. Secondary prevention programmes attempt to improve their prognosis. High participation rates are needed to ensure the desired population impact. We sought to assess the use of mammography and Pap smear and analyze predictors of screening adherence. We included women surveyed in the Spanish National Health Survey 2006. Cancer screening included mammography in the last 2 years and Pap smear in the last 3 years. The target age range of the screening programmes was 50-69 years in breast cancer screening and 25-64 years in cervical cancer screening. Independent variables included: sociodemographics, chronic diseases and lifestyles. Predictors of mammography or Pap smear adherence were explored using logistic regression. The screening coverage for the target age range was 84.1% (95% confidence interval=82.9-85.2) in breast cancer and 67.4% (95% confidence interval=66.5-68.4) in cervical cancer. Mammography uptake was positively associated with age, being married, higher educational level, having visited a physician or gynecologist, supplementary private health coverage and osteomuscular disease. Some unhealthy lifestyles were associated with nonadherence to mammography. Positive predictors of Pap smear adherence behaved in the same way as for mammography and also higher monthly incomes and eating a healthy diet were associated with higher screening compliance. In conclusion, adherence to breast cancer screening in Spain is acceptable in the target age group; nevertheless Pap smear screening must be improved. In both cases, an effort must be made to recruit those women who are less likely to undergo screening, as they are those who are at higher risk of suffering these diseases.
妇科癌症是发病率和死亡率的重要原因。二级预防计划试图改善其预后。需要高参与率以确保达到预期的人群影响。我们旨在评估乳房 X 光检查和巴氏涂片的使用情况，并分析筛查依从性的预测因素。我们纳入了在 2006 年西班牙国家健康调查中接受调查的女性。癌症筛查包括过去 2 年的乳房 X 光检查和过去 3 年的巴氏涂片检查。乳腺癌筛查的目标年龄范围为 50-69 岁，宫颈癌筛查的目标年龄范围为 25-64 岁。自变量包括：社会人口统计学、慢性疾病和生活方式。使用逻辑回归探索了乳房 X 光检查或巴氏涂片检查依从性的预测因素。在乳腺癌筛查中，目标年龄范围内的筛查覆盖率为 84.1%（95%置信区间=82.9-85.2），在宫颈癌筛查中为 67.4%（95%置信区间=66.5-68.4）。乳房 X 光检查的接受率与年龄、已婚、较高的教育水平、曾看过医生或妇科医生、补充私人健康保险以及肌肉骨骼疾病呈正相关。一些不健康的生活方式与乳房 X 光检查不依从有关。巴氏涂片检查依从性的阳性预测因素与乳房 X 光检查相同，较高的月收入和健康饮食也与更高的筛查依从性相关。总之，西班牙目标年龄组的乳腺癌筛查依从性是可以接受的；然而，巴氏涂片筛查必须加以改善。在这两种情况下，都必须努力招募那些不太可能接受筛查的女性，因为她们是那些患这些疾病风险较高的女性。
