Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, Geisel School of Medicine, Lebanon, New Hampshire, United States of America.
Rev Panam Salud Publica. 2013 Mar;33(3):174-82. doi: 10.1590/s1020-49892013000300003.
To assess the impact of health care access and socioeconomic determinants on Pap smear screening in Latin America.
Individual-level data was collected from the Demographic and Health Surveys in Bolivia, Brazil, Dominican Republic, Ecuador, Guatemala, Nicaragua, Peru, and Trinidad and Tobago between 1987 and 2008. Multivariate logistic regression analyses were used to identify socioeconomic and health care determinants of two outcomes: knowledge of Pap smears and recent Pap smear screening.
In all countries, the proportion of women with a recent Pap smear screening remained below 55%. Key determinants of knowledge of Pap smears were age, education, and recent doctor's visit. For recent Pap smear screening, key determinants were wealth and recent doctor's visit. Women were between 1.47 and 3.44 times more likely to have received a recent Pap smear if they had a recent doctor's visit. Even the poorest women with a recent doctor's visit were more likely to screen than the richest women without a recent visit.
These data suggest that visiting a doctor is an important determinant of cervical cancer screening in Latin America. Because screening may coincide with other medical visits, physicians could effectively encourage screening.
评估获得医疗保健和社会经济决定因素对拉丁美洲巴氏涂片筛查的影响。
1987 年至 2008 年间，从玻利维亚、巴西、多米尼加共和国、厄瓜多尔、危地马拉、尼加拉瓜、秘鲁和特立尼达和多巴哥的人口与健康调查中收集了个体层面的数据。采用多变量逻辑回归分析来确定社会经济和医疗保健因素对以下两个结果的影响：巴氏涂片检查的知晓情况和最近巴氏涂片筛查情况。
在所有国家，最近进行巴氏涂片筛查的妇女比例均低于 55%。巴氏涂片检查知晓情况的主要决定因素是年龄、教育程度和最近的医生就诊情况。对于最近的巴氏涂片筛查，主要决定因素是财富和最近的医生就诊情况。如果妇女最近看过医生，那么她们最近接受巴氏涂片筛查的可能性是未看过医生的妇女的 1.47 至 3.44 倍。即使是最贫困的最近看过医生的妇女，其筛查的可能性也大于最富有但未看过医生的妇女。
这些数据表明，在拉丁美洲，看医生是宫颈癌筛查的一个重要决定因素。由于筛查可能与其他医疗就诊同时进行，因此医生可以有效地鼓励筛查。
