Ramaswamy Megha, Kelly Patricia J, Koblitz Amber, Kimminau Kim S, Engelman Kimberly K
Department of Preventive Medicine and Public Health , University of Kansas School of Medicine, Kansas City, USA.
Women Health. 2011 Jul 22;51(5):423-41. doi: 10.1080/03630242.2011.590875.
In this exploratory study the authors investigated characteristics, including reported experiences of violence, related to incarcerated women's self-report of cervical cancer screening and cancer history and treatment. During a four month period in 2010, 204 women in Kansas City jails were surveyed. Multiple logistic regression models were used to examine the relations of socio-demographic and community characteristics and history of violence among the women to their cervical cancer screening, diagnosis, and treatment histories. Forty percent of the women in the current sample reported abnormal Pap histories, though only 6% of all Pap smears done in the U.S. are abnormal. Women who reported abuse histories in this study were found to be more likely to report having ever had an abnormal Pap smear (for physical abuse Odds Ratio [OR] = 6.05; CI 2.36, 15.54 and for past year intimate partner violence OR = 2.41; CI 1.09, 5.31). Participants who did not fear neighborhood violence were less likely to report an abnormal Pap history (OR = 0.57; CI 0.34, 0.96) and more likely to visit a family doctor for their Pap screenings (OR = 1.91; CI 1.01, 3.60). Women who perceived greater neighborhood violence had increased odds of reporting that they received Pap screenings in a hospital setting (OR = 1.47; CI 1.08, 2.00). Frequency of Pap screening did not differ in women who did and did not have fear of neighborhood violence. This study highlights the heightened cervical cancer risk experienced by women with criminal justice histories and suggests that violence at several levels has implications for cervical cancer prevention for these women.
在这项探索性研究中，作者调查了与被监禁女性宫颈癌筛查、癌症病史及治疗的自我报告相关的特征，包括所报告的暴力经历。在2010年的四个月期间，对堪萨斯城监狱中的204名女性进行了调查。使用多个逻辑回归模型来检验这些女性的社会人口统计学和社区特征以及暴力史与她们的宫颈癌筛查、诊断和治疗史之间的关系。当前样本中40%的女性报告巴氏涂片检查结果异常，而在美国所有巴氏涂片检查中只有6%的结果异常。在本研究中，报告有虐待史的女性更有可能报告曾有巴氏涂片检查结果异常（身体虐待的优势比[OR]=6.05；可信区间2.36,15.54；过去一年亲密伴侣暴力的OR=2.41；可信区间1.09,5.31）。不害怕邻里暴力的参与者报告巴氏涂片检查结果异常的可能性较小（OR=0.57；可信区间0.34,0.96），更有可能去家庭医生处进行巴氏涂片检查（OR=1.91；可信区间1.01,3.60）。认为邻里暴力更严重的女性报告在医院进行巴氏涂片检查的几率增加（OR=1.47；可信区间1.08,2.00）。是否害怕邻里暴力的女性在巴氏涂片检查频率上没有差异。这项研究强调了有刑事司法史的女性患宫颈癌的风险增加，并表明多个层面的暴力对这些女性的宫颈癌预防有影响。
