Department of Screening-based Research, Cancer Registry of Norway, Oslo, Norway.
BMC Public Health. 2011 Apr 26;11:264. doi: 10.1186/1471-2458-11-264.
Cervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance.
The Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP) registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression.
Women who attended screening were more likely than non-attendees to report that they were aware of the recommended screening interval, a history of sexually transmitted infections and a history of hormonal contraceptive and condom use. Attendance was also positively associated with being married/cohabiting, being a non-smoker and giving birth. Women who attended after being reminded were more likely than opportunistic attendees to be aware of cervical cancer and the recommended screening interval, but less likely to report a history of sexually transmitted infections and hormonal contraceptive use. Moreover, the likelihood of reminded attendance increased with age. Educational level did not significantly affect the women's attendance status in the fully adjusted models.
The likelihood of attendance in an organized screening program was higher among women who were aware of cervical screening, which suggests a potential for a higher attendance rate through improving the public knowledge of screening. Further, the lower awareness among opportunistic than reminded attendees suggests that physicians may inform their patients better when smears are taken at the physician's initiative.
有组织的宫颈癌筛查可降低发病率和死亡率。为了实现这一目标，参与者必须遵守筛查计划的出席建议。为了提高筛查参与率，需要了解依从性的预测因素。
挪威协调的宫颈癌筛查计划（NCCSP）登记了挪威所有的宫颈细胞学诊断，并单独提醒过去三年没有登记涂片的女性预约筛查。在本研究中，对挪威女性进行了一项关于生活方式和健康的问卷调查。回应率为 68%。为了研究 12058 名年龄在 25-45 岁符合条件的女性参加筛查的预测因素，将个体问卷数据与 NCCSP 的细胞学登记册进行了关联。我们将未参加者、机会主义参加者和提醒参加者区分开来，以进行为期四年的筛查。利用多变量逻辑回归确定了非参加者与参加者和提醒参加者与机会主义参加者之间的预测因素。
与未参加者相比，参加筛查的女性更有可能报告自己知道推荐的筛查间隔、性传播感染史和激素避孕和避孕套使用史。参加筛查还与已婚/同居、不吸烟和生育有关。与机会主义参加者相比，被提醒后参加筛查的女性更有可能了解宫颈癌和推荐的筛查间隔，但不太可能报告性传播感染和激素避孕使用史。此外，提醒参加的可能性随着年龄的增长而增加。在完全调整的模型中，教育水平并没有显著影响女性的参加状态。
在有组织的筛查计划中，那些知道宫颈癌筛查的女性参加的可能性更高，这表明通过提高公众对筛查的认识，可能会提高参与率。此外，机会主义参加者的知晓率低于提醒参加者，这表明医生在主动进行涂片检查时可以更好地告知患者。
