Açikgöz Ayla, Ergör Gül
Institute of Oncology, Department of Prevantive Oncology, Dokuz Eylul University, İzmir, Turkey.
Asian Pac J Cancer Prev. 2011;12(4):923-7.
Cervical cancer screening with Pap smear test is a cost-effective method. The Ministry of Health in Turkey recommends that it be performed once every five years after age 35. The purpose of this study was to determine the cervical cancer risk levels of women between 35 and 69, and the intervals they have the Pap smear test, and to investigate the relation between the two. This study was performed on 227 women aged between 35 and 69 living in Balçova District of İzmir province. Using the cervical cancer risk index program of Harvard School of Public Health, the cervical cancer risk level of 70% of the women was found below average, 22.1% average, and 7.9% above average. Only 52% of the women have had Pap smear test at least once in their lives. The percentage screening regularly in conformity with the national screening standard was 39.2%. Women in the 40-49 age group, were married, conformed significantly more (p<0.05) to the national screening standard. Compliance also increased with the level of education and decreased with the cervical cancer risk level (p<0.05). A logistic regression model was constructed including age, education level, menstruation state of the women and the economic level of the family. Not having the Pap smear test in conformity with the national cervical cancer screening standard in 35-39 age group was 2.52 times more than 40-49 age group, while it was 3.26 times more in 60-69 age group (p< 0.05). Not having Pap smear test in 35-39 age group more than other groups might result from lack of information on the cervical cancer national screening standard and the necessity of having Pap smear test. As for 60-69 age group, the low education level might cause not having Pap smear test. Under these circumstances, the cervical cancer risk levels should be determined and the individuals should be informed. Providing Pap smear test screening service to individuals in the target group of national screening standard, as a public service may resolve the inequalities due to age and educational differences.
巴氏涂片检查用于宫颈癌筛查是一种具有成本效益的方法。土耳其卫生部建议35岁以后每五年进行一次该项检查。本研究的目的是确定35至69岁女性的宫颈癌风险水平、她们进行巴氏涂片检查的间隔时间，并调查两者之间的关系。本研究对居住在伊兹密尔省巴尔乔瓦区的227名年龄在35至69岁之间的女性进行。使用哈佛公共卫生学院的宫颈癌风险指数程序，发现70%的女性宫颈癌风险水平低于平均水平，22.1%为平均水平，7.9%高于平均水平。只有52%的女性一生中至少进行过一次巴氏涂片检查。符合国家筛查标准定期进行筛查的比例为39.2%。40至49岁年龄组、已婚的女性显著更符合国家筛查标准（p<0.05）。依从性也随着教育水平的提高而增加，随着宫颈癌风险水平的升高而降低（p<0.05）。构建了一个逻辑回归模型，纳入了年龄、教育水平、女性月经状况和家庭经济水平。35至39岁年龄组未按照国家宫颈癌筛查标准进行巴氏涂片检查的情况是40至49岁年龄组的2.52倍，而在60至69岁年龄组则是3.26倍（p<0.05）。35至39岁年龄组未进行巴氏涂片检查的情况多于其他组，可能是由于对国家宫颈癌筛查标准以及进行巴氏涂片检查的必要性缺乏了解。至于60至69岁年龄组，教育水平低可能导致未进行巴氏涂片检查。在这种情况下，应确定宫颈癌风险水平并告知个体。作为一项公共服务，为国家筛查标准目标群体中的个体提供巴氏涂片检查筛查服务，可能会解决因年龄和教育差异导致的不平等问题。
