Abdullah Nasreen, Laing Robert S, Hariri Susan, Young Collette M, Schafer Sean
Acute and Communicable Disease Prevention Program, Oregon Public Health Division, Portland, Oregon, United States.
Acute and Communicable Disease Prevention Program, Oregon Public Health Division, Portland, Oregon, United States.
Cancer Epidemiol. 2016 Apr;41:106-12. doi: 10.1016/j.canep.2016.01.010. Epub 2016 Feb 18.
Human papillomavirus (HPV) vaccine should reduce cervical dysplasia before cervical cancer. However, dysplasia diagnosis is screening-dependent. Accurate screening estimates are needed.
To estimate the percentage of women in a geographic population that has had cervical cancer screening.
We analyzed claims data for (Papanicolau) Pap tests from 2008-2012 to estimate the percentage of insured women aged 18-39 years screened. We estimated screening in uninsured women by dividing the percentage of insured Behavioral Risk Factor Surveillance Survey respondents reporting previous-year testing by the percentage of uninsured respondents reporting previous-year testing, and multiplying this ratio by claims-based estimates of insured women with previous-year screening. We calculated a simple weighted average of the two estimates to estimate overall screening percentage. We estimated credible intervals using Monte-Carlo simulations.
During 2008-2012, an annual average of 29.6% of women aged 18-39 years were screened. Screening increased from 2008 to 2009 in all age groups. During 2009-2012, the screening percentages decreased for all groups, but declined most in women aged 18-20 years, from 21.5% to 5.4%. Within age groups, compared to 2009, credible intervals did not overlap during 2011 (except age group 21-29 years) and 2012, and credible intervals in the 18-20 year group did not overlap with older groups in any year.
This introduces a novel method to estimate population-level cervical cancer screening. Overall, percentage of women screened in Portland, Oregon fell following changes in screening recommendations released in 2009 and later modified in 2012.
人乳头瘤病毒（HPV）疫苗应能在宫颈癌发生前减少宫颈发育异常。然而，发育异常的诊断依赖于筛查。因此需要准确的筛查评估。
估计某一地理区域内接受过宫颈癌筛查的女性比例。
我们分析了2008年至2012年巴氏试验的理赔数据，以估计18至39岁参保女性的筛查比例。我们通过将报告上一年进行检测的参保行为危险因素监测调查受访者的比例除以报告上一年进行检测的未参保受访者的比例，并将该比率乘以基于理赔数据估算的上一年接受筛查的参保女性比例，来估算未参保女性的筛查情况。我们计算这两个估算值的简单加权平均数，以估算总体筛查比例。我们使用蒙特卡洛模拟来估计可信区间。
在2008年至2012年期间，18至39岁女性的年平均筛查率为29.6%。所有年龄组的筛查率在2008年至2009年有所上升。在2009年至2012年期间，所有组的筛查率均下降，但18至20岁女性下降最多，从21.5%降至5.4%。在各年龄组中，与2009年相比，2011年（21至29岁年龄组除外）和2012年的可信区间没有重叠，18至20岁年龄组的可信区间在任何一年都与年龄较大的组没有重叠。
本文介绍了一种估计人群层面宫颈癌筛查情况的新方法。总体而言，俄勒冈州波特兰市女性的筛查比例在2009年发布并于2012年修订的筛查建议变更后有所下降。
