Harlan L C, Bernstein A B, Kessler L G
National Cancer Institute, Bethesda, MD 20892.
Am J Public Health. 1991 Jul;81(7):885-90. doi: 10.2105/ajph.81.7.885.
The decline in death rates from cervical cancer in the United States has been widely attributed to the use of Papanicolaou (Pap) smears for early detection of cervical cancer.
Pap smear screening rates, beliefs about appropriate screening intervals and factors affecting screening were examined using 1987 National Health Interview Survey data.
Results indicate that through age 69, Blacks are screened at similar or higher rates than Whites. Hispanics, particularly those speaking only or mostly Spanish, are least likely to have received a Pap smear within the last three years. Of women who had never heard of or never had a Pap smear, nearly 80 percent reported contact with a medical practitioner in the past two years, while more than 90 percent reported a contact in the past five years. Overall, the most frequently reported reason for not having a recent Pap smear was procrastinating or not believing it was necessary.
Thus, in developing screening programs, Hispanics, particularly Spanish speakers, must be targeted. In addition, educational programs should target unscreened women who forego the test due to underestimating its importance, procrastination, or because their medical care provider did not suggest the procedure. Women must be intensively educated that Pap smears should be scheduled routinely to detect asymptomatic cervical cancer.
美国宫颈癌死亡率的下降普遍归因于使用巴氏涂片法进行宫颈癌的早期检测。
利用1987年全国健康访谈调查数据，对巴氏涂片筛查率、关于适当筛查间隔的看法以及影响筛查的因素进行了研究。
结果表明，在69岁之前，黑人的筛查率与白人相似或更高。西班牙裔，尤其是那些只说或主要说西班牙语的人，在过去三年中接受巴氏涂片检查的可能性最小。在从未听说过或从未做过巴氏涂片检查的女性中，近80%的人报告在过去两年中与医生有过接触，而超过90%的人报告在过去五年中有过接触。总体而言，最常报告的未进行近期巴氏涂片检查的原因是拖延或认为没有必要。
因此，在制定筛查计划时，必须针对西班牙裔，尤其是讲西班牙语的人。此外，教育计划应针对那些因低估其重要性、拖延或其医疗服务提供者未建议进行该检查而未接受筛查的女性。必须大力教育女性，巴氏涂片检查应定期安排以检测无症状宫颈癌。
