González Daisy, Suárez Erick L, Ortiz Ana Patricia
Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Womens Health Issues. 2015 May-Jun;25(3):254-61. doi: 10.1016/j.whi.2015.01.002. Epub 2015 Mar 31.
To assess the prevalence of cervical cancer screening through Papanicolaou (Pap) test utilization and its association with sexual behaviors among a population-based sample of Hispanic women in Puerto Rico (PR).
This study was a secondary data analysis of the database of a cross-sectional study of HPV infection in PR (2010-2013; n = 554 women). Pap test utilization (past 3 years) was self-reported and sexual risky behavior was defined as an index that considered the following sexual behaviors: early age of sexual debut (≤16 years), 11 or more lifetime sexual partners, and 2 or more sexual partners in the last year. Multivariable logistic regression was used to estimate the magnitude of the association between sexual risk behavior and Pap test utilization, after adjusting for socioeconomic and lifestyles characteristics.
The overall prevalence of Pap test utilization was 78.0%. Pap test screening varied with sexual behavior, with women with none or one risky sexual behavior having higher odds of Pap test utilization in the past 3 years (odds ratio [OR], 1.74; 95% CI, 1.03-2.93) compared with those with two or three risky sexual behaviors. This difference remained marginally significant (p < .10) after adjusting for age, educational attainment, smoking status and STI history (OR, 1.72; 95% CI, 0.96-3.08).
The prevalence of cervical cancer screening in this population (78%) is still below Healthy People 2020 recommendations (93%). Also, women with risky sexual behaviors are less likely to have been screened. Efforts to promote cervical screening programs should focus on these high-risk women as a method for cervical cancer prevention and control.
通过巴氏涂片检查的使用情况评估波多黎各（PR）西班牙裔女性人群中宫颈癌筛查的患病率及其与性行为的关联。
本研究是对PR一项HPV感染横断面研究数据库（2010 - 2013年；n = 554名女性）的二次数据分析。巴氏涂片检查的使用情况（过去3年）通过自我报告获取，性风险行为被定义为一个综合以下性行为的指标：初次性行为年龄早（≤16岁）、一生中有11个或更多性伴侣以及过去一年中有2个或更多性伴侣。在调整社会经济和生活方式特征后，使用多变量逻辑回归来估计性风险行为与巴氏涂片检查使用情况之间关联的强度。
巴氏涂片检查的总体使用率为78.0%。巴氏涂片检查筛查因性行为而异，与有两种或三种性风险行为的女性相比，没有或只有一种性风险行为的女性在过去3年中进行巴氏涂片检查的几率更高（优势比[OR]，1.74；95%置信区间，1.03 - 2.93）。在调整年龄、教育程度、吸烟状况和性传播感染史后，这种差异仍具有边缘显著性（p <.10）（OR，1.72；95%置信区间，0.96 - 3.08）。
该人群中宫颈癌筛查的患病率（78%）仍低于《健康人民2020》的建议水平（93%）。此外，有性风险行为的女性接受筛查的可能性较小。促进宫颈癌筛查项目的努力应将重点放在这些高危女性身上，作为预防和控制宫颈癌的一种方法。
