Dreier M, Borutta B, Töppich J, Bitzer E M, Walter U
Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover.
Gesundheitswesen. 2012 Nov;74(11):722-35. doi: 10.1055/s-0031-1286271. Epub 2011 Oct 19.
In the German statutory health insurance system, women can take part in free mammography and cervical cancer screening. The aim of this study is to investigate women's knowledge of, attitudes to and participation in these screening measures as well as the determinants of eligible women living in Germany.
We conducted a systematic literature search, supplemented by an Internet search, of Medline and other German and English databases for the period 2000-2010. Data extraction and quality assessment were carried out by 2 independent reviewers. Data synthesis was qualitative.
We identified 12 studies on mammography and cervical cancer screening. Most women were found to be aware of the option of free screening. The majority of women were able to name risk factors for breast cancer correctly. This was not the case in cervical cancer, where women said they were insufficiently informed. To a significant extent, they were also uninformed about the benefits of screening and incidence of false-positive and false-negative test results in mammography. In 2007, 54% of the invited women took part in the organised mammography screening program with large variations in participation rate among the Federal states. It appears that better educated women or those with a private health insurance participate in the programme less frequently. However, one third of the non-participants attend a mammography outside the screening program. Data for participation in cervical cancer screening are inconsistent. There is some evidence that younger women, married women and those with higher education are more likely to participate in the screening.
The interviewees' substantial lack of knowledge underscores the need for optimising communication on the aims, benefits and risks of screening tests to enable women to make an informed decision. It is desirable to continuously monitor women's knowledge about and participation in screening and determinants thereof with a view to laying the foundations for target group-specific information strategies.
在德国法定医疗保险体系中，女性可免费参加乳房X线筛查和宫颈癌筛查。本研究旨在调查女性对这些筛查措施的了解、态度及参与情况，以及德国符合条件女性的决定因素。
我们对2000 - 2010年期间的Medline以及其他德语和英语数据库进行了系统的文献检索，并辅以互联网搜索。数据提取和质量评估由2名独立评审员进行。数据综合采用定性方法。
我们确定了12项关于乳房X线筛查和宫颈癌筛查的研究。发现大多数女性知晓免费筛查这一选项。大多数女性能够正确说出乳腺癌的风险因素。宫颈癌方面情况并非如此，女性表示她们了解的信息不足。在很大程度上，她们对筛查的益处以及乳房X线筛查中假阳性和假阴性检测结果的发生率也不了解。2007年，54%受邀女性参加了有组织的乳房X线筛查项目，各联邦州的参与率差异很大。似乎受教育程度较高的女性或拥有私人医疗保险的女性参与该项目的频率较低。然而，三分之一的未参与者会在筛查项目之外进行乳房X线检查。宫颈癌筛查的参与数据并不一致。有证据表明，年轻女性、已婚女性和受过高等教育的女性更有可能参与筛查。
受访者知识的严重匮乏凸显了优化关于筛查检测的目的、益处和风险的沟通的必要性，以便女性能够做出明智的决定。持续监测女性对筛查的了解、参与情况及其决定因素是可取的，以便为针对特定目标群体的信息策略奠定基础。
