University of Puerto Rico Comprehensive Cancer Center and University of Puerto Rico Medical Sciences Campus, PMB 711, 89 De Diego Ave, Ste 105, San Juan, Puerto Rico 00927-6346.
Prev Chronic Dis. 2010 May;7(3):A58. Epub 2010 Apr 15.
Racial/ethnic disparities in cervical cancer screening exist in the United States; rates are lowest among women who live in Puerto Rico. We identified factors associated with cervical cancer screening among women aged 18 years or older living in Puerto Rico.
We included women who participated in the Puerto Rico Behavioral Risk Factor Surveillance System in 2006 who had not had a hysterectomy (n = 2,206). We calculated the weighted population prevalence estimates of Papanicolaou (Pap) test screening in the past 3 years and used logistic regression models to assess factors associated with screening.
Most participants (71.9% [95% confidence interval (CI) = 69.4%-74.4%]) reported having had a Pap test in the preceding 3 years. Factors associated with screening in multivariate analysis included routine checkup in the past year and leisure-time physical activity. Compared with women with a household income less than $15,000, those with higher incomes were more likely to have had a Pap test. Similarly, divorced or separated women were more likely to have been screened (odds ratio [OR] = 1.13; 95% CI = 1.12-1.15) than those who were married/living together. We did not find associations between screening behavior and education, health care coverage, body mass index, or smoking status.
The prevalence of cervical cancer screening in Puerto Rico is below the 90% recommendation established by Healthy People 2010. Our findings regarding factors associated with Pap screening behavior identified population subgroups who are underscreened and who may benefit from targeted interventions and screening programs.
在美国，宫颈癌筛查存在种族/民族差异；波多黎各的女性最低。我们确定了居住在波多黎各的 18 岁及以上女性进行宫颈癌筛查的相关因素。
我们纳入了 2006 年参加波多黎各行为风险因素监测系统且未行子宫切除术的女性（n=2206）。我们计算了过去 3 年巴氏试验（Pap）筛查的加权人口流行率，并使用逻辑回归模型评估与筛查相关的因素。
大多数参与者（71.9%[95%置信区间（CI）=69.4%-74.4%]）报告在过去 3 年内接受过 Pap 检测。多变量分析中与筛查相关的因素包括过去一年的常规检查和闲暇时间的体育锻炼。与收入低于 15000 美元的女性相比，收入较高的女性更有可能进行 Pap 检测。同样，离婚或分居的女性比已婚/同居的女性更有可能接受筛查（比值比[OR] = 1.13；95% CI = 1.12-1.15）。我们未发现筛查行为与教育程度、医疗保险覆盖范围、体重指数或吸烟状况之间存在关联。
波多黎各的宫颈癌筛查率低于《2010 年健康人》中规定的 90%的推荐值。我们对与 Pap 筛查行为相关的因素的研究结果确定了未充分筛查的人群亚组，他们可能受益于有针对性的干预措施和筛查计划。
