Choi Kui Son, Lee Duk Hee, Jung Kap Yeol, Son Jieun, Jang Tae Won, Kim Yoon Kyu, Shin Hai Rim
National Cancer Center Research Institute, Korea.
J Prev Med Public Health. 2004 May;37(2):166-73.
Cervical cancer is the second most frequent cancer among women in Busan. The Pap smear test could have a significant effect on detecting cervical cancer, and enhancing their rate of use is an important strategy for reducing the incidence and mortality of cervical cancer. This study aimed to evaluate the factors associated with the past use of the Pap smear test in Korean women.
A population-based survey was carried out in Busan between November 1999 and March 2000. 1, 673 participants were randomly selected from 2, 684 women in Busan, using a 2-stage cluster sampling method, and interviewed in their homes. Their socio-demographic characteristics, smoking, drinking, familial cancer history, Pap smear screening history, reproductive and menstrual factors, sexual habits and use of contraceptive methods data were collected by a trained interviewer using a questionnaire. The use of the screening test was defined by a self-report from the participants on how many times they had had a Pap smear test in their lifetime, and when they had received their latest examination.
Of the 1, 673 respondents (62.3% response rate), 57.6% had had a Pap smear test during her life (mean number, 2.3). Among the health examination participants (1, 064), 961 (90.3%) reported having sexual experience and 70.9% of these had had a Pap smear test. In a multiple logistic regression analysis, statistically significant relationships were observed for age groups and the Pap smear test rate (odds ratio, OR for 35-44 years=2.45; OR for 45-54 years=3.41; OR for 55 years=2.60; reference, under 34 years). The married or cohabiting women were more likely to have used the Pap smear test than those separated or widowed (OR=1.73). Among the reproductive behavioral measures, the number of births (OR for 3 births=4.22; OR for 2 births=3.95; OR for 1 births=3.38; reference, 0 births) and husband's extra-marital affairs (OR=1.50) were associated with the rates of use of Pap smear tests.
It appears that the most important contributing factors to cervical cancer screening were age, marital status and number of births. A positive association was also observed for the husband's extra-marital affairs. This study enabled us to systematically assess the relationship between Pap smear rates and risk factors for cervical cancer. It is hoped that this study will make a significant contribution to the accumulating scientific evidence on the identification of factors associated with cervical cancer screening in Korea.
宫颈癌是釜山女性中第二常见的癌症。巴氏涂片检查对宫颈癌的检测可能有显著影响，提高其使用率是降低宫颈癌发病率和死亡率的重要策略。本研究旨在评估韩国女性过去使用巴氏涂片检查的相关因素。
1999年11月至2000年3月在釜山进行了一项基于人群的调查。采用两阶段整群抽样方法，从釜山的2684名女性中随机选取1673名参与者，并在她们家中进行访谈。由经过培训的访谈员使用问卷收集她们的社会人口学特征、吸烟、饮酒、家族癌症史、巴氏涂片筛查史、生殖和月经因素、性行为习惯以及避孕方法使用数据。筛查测试的使用由参与者自我报告其一生中进行巴氏涂片检查的次数以及最近一次检查的时间来定义。
在1673名受访者中（应答率为62.3%），57.6%的人一生中进行过巴氏涂片检查（平均次数为2.3次）。在健康检查参与者（1064人）中，961人（90.3%）报告有性经历，其中70.9%的人进行过巴氏涂片检查。在多因素逻辑回归分析中，观察到年龄组与巴氏涂片检查率之间存在统计学显著关系（优势比，35 - 44岁的OR = 2.45；45 - 54岁的OR = 3.41；55岁及以上的OR = 2.60；参照组为34岁以下）。已婚或同居女性比分居或丧偶女性更有可能使用巴氏涂片检查（OR = 1.73）。在生殖行为指标中，生育次数（生育3次的OR = 4.22；生育2次的OR = 3.95；生育1次的OR = 3.38；参照组为未生育）和丈夫的婚外情（OR = 1.50）与巴氏涂片检查使用率相关。
看来宫颈癌筛查的最重要影响因素是年龄、婚姻状况和生育次数。丈夫的婚外情也呈现出正相关。本研究使我们能够系统地评估巴氏涂片检查率与宫颈癌危险因素之间的关系。希望本研究将为积累关于韩国宫颈癌筛查相关因素识别的科学证据做出重大贡献。
