Guo Fangjian, Hirth Jacqueline M, Berenson Abbey B
Department of Obstetrics and Gynecology, and Center for Interdisciplinary Research in Women's Health, The University of Texas Medical Branch , Galveston, TX.
J Womens Health (Larchmt). 2015 Aug;24(8):641-7. doi: 10.1089/jwh.2014.5129. Epub 2015 May 26.
Cardiovascular disease (CVD) is common among women and is a leading cause of death in the United States. This study assessed the impact of CVD on compliance with the US Preventive Services Task Force guidelines for cervical and breast cancer screening among U.S. adult women.
A cross-sectional study was conducted on 17,408 women using data from the National Health Interview Survey 2013. A total of 11,788 respondents (21-65 years old) with complete information on Pap smear and 11,409 women (40+ years old) with complete information on mammography compliance were included. Multivariate logistic regression models were used to assess the impact of CVD on cervical and breast cancer screening practices.
Women with CVD were marginally more likely to have had a mammogram in accordance with guidelines (odds ratio 1.17; 95% confidence interval 1.04-1.31) than those without CVD. However, compliance with Pap tests was similar (80.6% vs 82.3%, p>0.05) between the two groups. Myocardial infarction was associated with reduced odds of Pap smear compliance (odds ratio: 0.30; 95% confidence interval 0.18-0.51).
Women with prior myocardial infarction should be encouraged to continue receiving regular Pap smears. More research is needed to assess whether observed differences in Pap testing between patients with and without a history of myocardial infarction result from lack of provider recommendation or from patient noncompliance with their recommendations.
心血管疾病(CVD)在女性中很常见,是美国主要的死亡原因。本研究评估了心血管疾病对美国成年女性遵守美国预防服务工作组宫颈癌和乳腺癌筛查指南的影响。
利用2013年国家健康访谈调查的数据,对17408名女性进行了横断面研究。纳入了11788名(21 - 65岁)有巴氏涂片完整信息的受访者以及11409名(40岁及以上)有乳房X光检查依从性完整信息的女性。使用多变量逻辑回归模型评估心血管疾病对宫颈癌和乳腺癌筛查实践的影响。
患有心血管疾病的女性比未患心血管疾病的女性更有可能按照指南进行乳房X光检查(优势比1.17;95%置信区间1.04 - 1.31)。然而,两组之间巴氏试验的依从性相似(80.6%对82.3%,p>0.05)。心肌梗死与巴氏涂片检查依从性降低的几率相关(优势比:0.30;95%置信区间0.18 - 0.51)。
应鼓励有心肌梗死病史的女性继续接受定期巴氏涂片检查。需要更多研究来评估有无心肌梗死病史患者在巴氏试验中观察到的差异是由于缺乏医生建议还是患者未遵守其建议所致。