Centre for Clinical Epidemiology, Jewish General Hospital, Montreal, Canada.
BMC Public Health. 2013 May 3;13:438. doi: 10.1186/1471-2458-13-438.
The Canadian circumpolar Inuit population has a higher incidence rate of cervical cancer than the general population and the majority of cases occur among underscreened women. The objectives of this study were to determine Pap smear utilization rates and to determine factors associated with time-inappropriate use of cervical cancer screening among a cohort of Inuit women from Nunavik, Quebec, Canada.
This study utilizes baseline information collected from a cohort formed between January 2002 and December 2007 to study the natural history of HPV among Inuit women aged 21-69 years in Nunavik, Quebec. Cervical cancer screening history and other variables were obtained from a baseline questionnaire and medical chart review. Unconditional logistic regression was used to estimate the odds ratios and 95% confidence intervals for potential predictors of not having a Pap smear within the previous 3 years prior to cohort entry.
A total of 403 Inuit women who had a baseline questionnaire and chart review were included. The mean age of the study population was 34.2 years. In the three years prior to study entry, 25% of women did not have a Pap smear. Older age and never giving birth were significant predictors of time-inappropriate Pap smear use.
Our results suggest that older women and women who are not accessing reproductive care have a lower compliance with time-appropriate cervical cancer screening and future research should address potential strategies to increase screening coverage among this group.
加拿大环极因纽特人群的宫颈癌发病率高于一般人群,且大多数病例发生在筛查不足的女性中。本研究的目的是确定巴氏涂片的使用情况,并确定与魁北克努纳武特因纽特妇女队列中宫颈癌筛查时间不当相关的因素。
本研究利用 2002 年 1 月至 2007 年 12 月期间组建的队列的基线信息,研究 HPV 在魁北克努纳武特 21-69 岁因纽特妇女中的自然史。通过基线问卷和病历回顾获取宫颈癌筛查史和其他变量。使用非条件逻辑回归估计潜在预测因子在队列入组前 3 年内未进行巴氏涂片的比值比和 95%置信区间。
共纳入 403 名有基线问卷和图表审查的因纽特妇女。研究人群的平均年龄为 34.2 岁。在研究入组前的三年内,25%的女性没有进行巴氏涂片检查。年龄较大和从未生育是巴氏涂片检查时间不当的显著预测因素。
我们的结果表明,年龄较大的妇女和未接受生殖保健的妇女对宫颈癌筛查的依从性较低,未来的研究应针对这一群体的潜在策略,以增加筛查覆盖率。