Radde Kathrin, Gottschalk Andrea, Bussas Ulrike, Schülein Stefanie, Schriefer Dirk, Seifert Ulrike, Neumann Anne, Kaiser Melanie, Blettner Maria, Klug Stefanie J
Cancer Epidemiology, University Cancer Center, University Hospital, Technische Universität Dresden, Dresden, Germany.
Division of Preventive Oncology, National Center for Tumor Diseases and German Cancer Research Center, Heidelberg, Germany.
Int J Cancer. 2016 Sep 1;139(5):1018-30. doi: 10.1002/ijc.30146. Epub 2016 May 13.
The effect of different invitation models on participation in cervical cancer screening (CCS) was investigated in a randomized population-based cohort study in Germany. Participants were randomly selected via population registries and randomized into intervention Arm A (invitation letter) and Arm B (invitation letter and information brochure) or control Arm C (no invitation). The intervention and control arms were compared with regard to 3-year participation and the two invitation models were compared between intervention arms. Of the 7,758 eligible women aged 30-65 years, living in the city of Mainz and in the rural region of Mainz-Bingen, 5,265 were included in the analysis. Differences in proportions of women attending CCS were investigated and logistic regression was performed to analyze various factors influencing participation. In the intervention group, 91.8% participated in CCS compared to 85.3% in the control group (p < 0.0001), with a 6.6 percentage point increase in participation [95% confidence interval (CI) 4.6-8.6] and an adjusted odds ratio (OR) of 2.69 (95% CI 2.15-3.37). Effect estimators increased to 21.9 percentage points (95% CI 16.7-27.1) and an OR of 3.64 (95% CI 2.74-4.82), respectively, when women who participated in screening annually were excluded from the analysis. The invitation letter was particularly effective among women with lower school education, migrant women and older women. No difference in participation was found between the intervention Arm A and Arm B. An accompanying information brochure did not motivate more women to undergo CCS. However, a written invitation statistically significantly increased participation in CCS in Germany.
在德国一项基于人群的随机队列研究中，调查了不同邀请模式对宫颈癌筛查（CCS）参与率的影响。参与者通过人口登记处随机选取，并随机分为干预组A（邀请信）和干预组B（邀请信和信息手册）或对照组C（无邀请）。比较了干预组和对照组的3年参与率，并对两个干预组的两种邀请模式进行了比较。在美因茨市和美因茨 - 宾根农村地区居住的7758名30 - 65岁符合条件的女性中，5265名被纳入分析。研究了参加CCS的女性比例差异，并进行逻辑回归分析影响参与的各种因素。干预组中，91.8%的女性参与了CCS，而对照组为85.3%（p < 0.0001），参与率提高了6.6个百分点[95%置信区间（CI）4.6 - 8.6]，调整后的优势比（OR）为2.69（95% CI 2.15 - 3.37）。当将每年参加筛查的女性排除在分析之外时，效应估计值分别增至21.9个百分点（95% CI 16.7 - 27.1）和OR为3.64（95% CI 2.74 - 4.82）。邀请信在受教育程度较低的女性、移民女性和老年女性中特别有效。干预组A和干预组B之间在参与率上没有差异。一份附带的信息手册并没有促使更多女性接受CCS。然而，在德国，书面邀请在统计学上显著提高了CCS的参与率。
