Preventive Medicine and Public Health Teaching and Research Unit, Rey Juan Carlos University, Alcorcon, Spain.
Eur J Cancer Prev. 2012 Jan;21(1):82-8. doi: 10.1097/CEJ.0b013e32834a7e46.
Cervical cancer remains a public health problem in developed countries. Early detection of both premalignant lesions and cervical cancer through an appropriate screening programme may decrease its incidence and mortality. High rates of participation are essential to ensure the desired impact on the population. The aims of this study were to assess the use of Pap smears in Spain in 2009 to identify factors associated with screening adherence (predictors) and assess the trend from 2003 to 2009. We included women surveyed in the European Health Interview Survey for Spain. Cervical cancer screening included self-reported Pap smears over the last 3 years. The target age range was 25-64 years. The following independent variables were analysed: sociodemographic variables, chronic conditions, and lifestyle. Predictors of Pap smear adherence were explored using multivariate logistic regression. The screening coverage in the target population was 66.1% (95% confidence interval: 64.8-67.4). Undergoing Pap smears was associated positively with the following: being married, higher levels of education and income, having visited a general practitioner in previous weeks, and suffering from musculoskeletal disease. Belonging to an older age group (55-64 years) and obesity were associated with nonadherence to Pap smears. We did not find significant differences when we compared cervical cancer screening adherence over time since 2003. Adherence to cervical cancer screening in Spain does not seem to be improving. An effort must be made, and the implementation of population-based programmes instead of opportunistic screening could be considered, to recruit women who are less likely to undergo screening.
在发达国家，宫颈癌仍然是一个公共卫生问题。通过适当的筛查计划早期发现癌前病变和宫颈癌，可能会降低其发病率和死亡率。高参与率对于确保对人群产生预期影响至关重要。本研究的目的是评估 2009 年西班牙巴氏涂片的使用情况，以确定与筛查依从性相关的因素（预测因素），并评估 2003 年至 2009 年的趋势。我们纳入了在西班牙进行的欧洲健康访谈调查中接受调查的女性。宫颈癌筛查包括过去 3 年中自我报告的巴氏涂片检查。目标年龄范围为 25-64 岁。分析了以下独立变量：社会人口统计学变量、慢性疾病和生活方式。使用多变量逻辑回归探索了巴氏涂片依从性的预测因素。目标人群的筛查覆盖率为 66.1%（95%置信区间：64.8-67.4）。进行巴氏涂片检查与以下因素呈正相关：已婚、教育程度和收入水平较高、过去几周内看过全科医生，以及患有肌肉骨骼疾病。属于年龄较大的年龄组（55-64 岁）和肥胖与不进行巴氏涂片检查相关。我们没有发现自 2003 年以来随着时间的推移，宫颈癌筛查依从性存在显著差异。西班牙宫颈癌筛查的依从性似乎没有改善。必须做出努力，可以考虑实施基于人群的方案而不是机会性筛查，以招募不太可能进行筛查的女性。
