78 家性传播疾病诊所中的宫颈癌筛查和预防-美国，2014-2015 年。
Cervical Cancer Screening and Prevention in 78 Sexually Transmitted Disease Clinics-United States, 2014-2015.
机构信息
From the *National Coalition of STD Directors, Washington, DC; †Rural Center for AIDS/STD Prevention, Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN; ‡Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, §Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
出版信息
Sex Transm Dis. 2017 Oct;44(10):637-641. doi: 10.1097/OLQ.0000000000000659.
BACKGROUND
Human papillomavirus (HPV) infections cause approximately 30,700 cancers annually among US men and women, cervical cancer being the most common. Human papillomavirus vaccination is recommended routinely for US girls and boys at age 11 to 12 years, and for those not previously vaccinated, through age 26 and 21 years for women and men, respectively. Our objective was to assess current cervical cancer screening and HPV vaccination practices among sexually transmitted disease (STD) clinics in the United States.
METHODS
We surveyed a geographically diverse convenience sample of US STD clinics identified by members of the National Coalition of STD Directors within 65 state, territorial, and local jurisdictions. An online multiple-choice survey about clinical services was administered to clinic directors or designees during October 2014 to February 2015.
RESULTS
Survey respondents included 78 clinics from 46 states and territories. Of these clinics, 31 (39.7%) offered both cervical cancer screening and HPV vaccination, 6 (7.7%) offered cervical cancer screening only, 21 (26.9%) offered HPV vaccination only, and 20 (25.6%) offered neither cervical cancer prevention service. Among those not offering the service, the most commonly reported barrier to cervical cancer screening was time constraints (25/41, 61.0%); for HPV vaccination it was reimbursement (11/26, 42.3%).
CONCLUSIONS
By early 2015, in a geographically diverse group of 78 STD clinics, 39.7% provided nationally recommended HPV vaccination and cervical cancer screening, whereas 25.6% provided neither. Further research could identify strategies for STD clinics to reduce HPV-associated cancers by increasing provision of HPV vaccination and cervical cancer screening services, particularly among medically underserved populations.
背景
人乳头瘤病毒（HPV）感染导致美国男女每年约有 30700 人患癌症，其中宫颈癌最为常见。美国建议对 11 至 12 岁的男女儿童常规接种 HPV 疫苗，对于之前未接种疫苗的人群，女性和男性分别在 26 岁和 21 岁前接种。我们的目的是评估美国性传播疾病（STD）诊所目前的宫颈癌筛查和 HPV 疫苗接种情况。
方法
我们调查了美国 STD 诊所的地理多样性便利样本，这些诊所是由全国性传播疾病主任联盟的成员在 65 个州、领地和地方司法管辖区内确定的。2014 年 10 月至 2015 年 2 月期间，向诊所主任或指定人员进行了关于临床服务的在线多项选择调查。
结果
调查对象包括来自 46 个州和领地的 78 家诊所。这些诊所中，31 家（39.7%）提供宫颈癌筛查和 HPV 疫苗接种服务，6 家（7.7%）仅提供宫颈癌筛查服务，21 家（26.9%）仅提供 HPV 疫苗接种服务，20 家（25.6%）既不提供宫颈癌预防服务，也不提供 HPV 疫苗接种服务。在不提供该服务的诊所中，报告的宫颈癌筛查最常见的障碍是时间限制（25/41，61.0%）；HPV 疫苗接种的最常见障碍是报销（11/26，42.3%）。
结论
截至 2015 年初，在地理分布广泛的 78 家 STD 诊所中，有 39.7%提供了国家推荐的 HPV 疫苗接种和宫颈癌筛查，而有 25.6%的诊所两者都不提供。进一步的研究可以确定 STD 诊所通过增加 HPV 疫苗接种和宫颈癌筛查服务来减少 HPV 相关癌症的策略，特别是在医疗服务不足的人群中。
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