Department of Epidemiology, Houston, TX; Division of Cancer Prevention and Population Science, Houston, TX; Department of Gynecologic Oncology and Reproductive Medicine, Houston, TX.
Department of Epidemiology, Houston, TX.
Ann Epidemiol. 2019 Aug;36:40-47. doi: 10.1016/j.annepidem.2019.06.002. Epub 2019 Jun 21.
In the United States, recommended options for cervical cancer screening in women aged 30 years or older include cytology alone or a combination of cytology and human papillomavirus (HPV) testing (co-testing). Although there is a body of evidence suggesting that co-testing may be the preferred screening option in this group of women, little is known about the characteristics of women who screen for cervical cancer with co-testing.
A multistage area probability design-based survey was administered to a representative sample of Texas residents. Of the 1348 female respondents, 572 women aged 30 years or older were included in this analysis. Population-weighted survey logistic regression was used to identify determinants of cervical screening with co-testing versus screening with cytology alone.
Women vaccinated against HPV (aOR: 4.48, 95% CI: 1.25-15.97) or hepatitis B virus [aOR: 2.48 (1.52-4.02)], those with a personal cancer history [aOR: 2.96 (1.29-6.77)], and hormonal contraception users [aOR: 2.03 (1.03-3.97)] were more likely to be screened with co-testing than with cytology alone. Moreover, the likelihood of being screened with co-testing decreased with increasing age and decreasing annual household income.
Benefits and indications of co-testing should be better explained to women and health care providers.
在美国，推荐 30 岁及以上女性进行宫颈癌筛查的方案包括单独细胞学检查或细胞学检查联合人乳头瘤病毒（HPV）检测（联合检测）。尽管有大量证据表明联合检测可能是该年龄段女性首选的筛查方法，但对于选择联合检测进行宫颈癌筛查的女性特征知之甚少。
采用多阶段区域概率设计对得克萨斯州居民进行了一项代表性调查。在 1348 名女性应答者中，有 572 名 30 岁及以上的女性被纳入本分析。采用人群加权调查逻辑回归来确定与单独细胞学检查相比，联合检测用于宫颈癌筛查的决定因素。
HPV 疫苗接种者（aOR：4.48，95%CI：1.25-15.97）或乙型肝炎病毒（aOR：2.48[1.52-4.02]）接种者、有个人癌症史者（aOR：2.96[1.29-6.77]）和激素避孕药使用者（aOR：2.03[1.03-3.97]）更有可能进行联合检测，而不是单独细胞学检查。此外，联合检测的可能性随着年龄的增加和家庭年收入的减少而降低。
应向女性和卫生保健提供者更好地解释联合检测的益处和适应证。
