Jones Marie, Lee Marette, Ogilvie Gina, Murray Melanie C M, Money Deborah, Collins Rebecca, Albert Arianne, Mitchell-Foster Sheona
Northern Medical Program, University of British Columbia, Prince George, BC.
Division of Gynecologic Oncology, University of British Columbia, Vancouver, BC.
J Obstet Gynaecol Can. 2018 Nov;40(11):1401-1408. doi: 10.1016/j.jogc.2018.02.009. Epub 2018 Jun 29.
This study seeks to identify barriers to colposcopy examination faced by patients living in Northern BC to improve outcomes for women at risk of developing cervical cancer.
A retrospective chart review (n = 309) was conducted in the four colposcopy clinics in Northern BC to collect information regarding patients who were referred for colposcopy after abnormal cytology. Demographic factors associated with non-attendance were identified as barriers to accessing care. Aggregate data from the Cervical Cancer Screening Program (n = 4265) were used to calculate wait times by health region across BC.
The odds of having missed an appointment was highest for women who were pregnant (OR 4.0) or attending site D vs. site A (OR 6.0); however, only clinic location remained significant in a multivariable model. Wait times were longer for women who had ever missed appointments, and varied among the sites, with site A and D having significantly longer wait times than the remaining sites. The Northern Health Authority had the longest overall median colposcopy wait time for high-grade cytology in the province at 41 days longer than the provincial average of 62 days.
The Northern Health Authority faces unique challenges associated with geography and patient population that are associated with longer wait times for colposcopy when compared with other health authorities in the province.
本研究旨在确定居住在不列颠哥伦比亚省北部的患者在接受阴道镜检查时面临的障碍，以改善有患宫颈癌风险的女性的治疗结果。
对不列颠哥伦比亚省北部的四家阴道镜诊所进行了一项回顾性病历审查（n = 309），以收集有关细胞学异常后被转诊进行阴道镜检查的患者的信息。与未就诊相关的人口统计学因素被确定为获得护理的障碍。来自宫颈癌筛查项目（n = 4265）的汇总数据用于计算不列颠哥伦比亚省各卫生区域的等待时间。
怀孕的女性（比值比4.0）或在D地点就诊而非A地点就诊的女性（比值比6.0）错过预约的几率最高；然而，在多变量模型中，只有诊所位置仍然具有统计学意义。曾经错过预约的女性等待时间更长，各地点之间也有所不同，A地点和D地点的等待时间明显长于其他地点。北部卫生局在该省高级别细胞学阴道镜检查的总体中位等待时间最长，比全省平均水平62天长41天。
与该省其他卫生局相比，北部卫生局在地理和患者群体方面面临独特挑战，这些挑战与阴道镜检查的较长等待时间相关。
