Labeit Alexander Michael, Peinemann Frank
University of Sheffield, School of Health and Related Sciences, Sheffield, United Kingdom.
FOM University of Applied Science for Economics & Management, Essen, Germany.
PLoS One. 2017 Apr 5;12(4):e0174363. doi: 10.1371/journal.pone.0174363. eCollection 2017.
In the UK, women are requested to attend a cervical cancer test every 3 years as part of the NHS Cervical Screening Programme. This analysis compares the determinants of a cervical cancer screening examination with the determinants of a GP visit in the same year and investigates if cervical cancer screening participation is more likely for women who visit their GP.
A recursive probit model was used to analyse the determinants of GP visits and cervical cancer screening examinations. GP visits were considered to be endogenous in the cervical cancer screening examination. The analysed sample consisted of 52,551 observations from 8,386 women of the British Household Panel Survey.
The analysis showed that a higher education level and a worsening self-perceived health status increased the probability of a GP visit, whereas smoking decreased the probability of a GP visit. GP visits enhanced the uptake of a cervical cancer screening examination in the same period. The only variables which had the same positive effect on both dependent variables were higher education and living with a partner. The probability of a cervical cancer screening examination increased also with previous cervical cancer screening examinations and being in the recommended age groups. All other variables had different results for the uptake of a GP visit or a cervical cancer screening examination.
Most of the determinants of visiting a GP and cervical cancer screening examination differ from each other and a GP visit enhances the uptake of a smear test.
在英国,作为国民医疗服务体系宫颈癌筛查计划的一部分,要求女性每3年参加一次宫颈癌检测。本分析比较了宫颈癌筛查检查的决定因素与同年全科医生就诊的决定因素,并调查了看全科医生的女性参加宫颈癌筛查的可能性是否更高。
采用递归概率模型分析全科医生就诊和宫颈癌筛查检查的决定因素。在宫颈癌筛查检查中,全科医生就诊被视为内生变量。分析样本包括来自英国家庭调查小组8386名女性的52551条观测数据。
分析表明,较高的教育水平和自我感觉健康状况变差会增加看全科医生的概率,而吸烟会降低看全科医生的概率。看全科医生会提高同期宫颈癌筛查检查的接受率。对两个因变量都有相同积极影响的唯一变量是较高的教育水平和与伴侣同住。宫颈癌筛查检查的概率也会随着之前的宫颈癌筛查检查以及处于推荐年龄组而增加。所有其他变量在看全科医生或宫颈癌筛查检查的接受率方面有不同结果。
看全科医生和宫颈癌筛查检查的大多数决定因素彼此不同,看全科医生会提高涂片检查的接受率。