加纳女性的宫颈癌筛查实践：来自世卫组织全球老龄化和成人健康研究第二波调查的证据。
Cervical cancer screening practices among women in Ghana: evidence from wave 2 of the WHO study on global AGEing and adult health.
机构信息
Department of Community Health, School of Public Health,College of Health Sciences, University of Ghana, Accra, Ghana.
Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
出版信息
BMC Womens Health. 2020 Mar 5;20(1):49. doi: 10.1186/s12905-020-00915-9.
BACKGROUND
Cervical cancer is the third most common cancer that affects women worldwide. It has been and remains the leading cause of cancer mortality among women in Ghana. Despite the fact that cervical cancer is preventable through early detection and treatment of precancerous lesions, anecdotal evidence from gynaecological clinics in Ghana indicates that most patients present with a late stage of the disease. This study assesses the cervical cancer screening practices among women in Ghana.
METHODS
Data from the World Health Organization's (WHO) multi-country Study on AGEing and adult health (SAGE) wave 2 conducted between 2014 and 2015 in Ghana was used. We employed binary logistic regression models to analyse data on 2711 women to examine factors associated with having pelvic examination among women aged ≥18 years. Among those who had pelvic examination, we applied binary logistic regression models to analyse factors associated with receiving Pap smear test as a subgroup analysis.
RESULTS
Of the 2711 women aged 18 years or older surveyed, 225 (8.3%) had ever had a pelvic examination and only 66 (2.4%) of them reported ever having done a Pap smear test. For those who had pelvic examination, only 26.94% had Pap smear test. Ethnic group, marital status, father's educational level and difficulty with self-care were independently associated with undergoing pelvic examination. Only age and healthcare involvement were independently associated with pelvic examination within the past 5 years to the survey. Marital status, satisfaction with healthcare and healthcare involvement were independently associated with Pap smear test.
CONCLUSION
Even though cervical cancer is preventable through early detection of precancerous lesions using Pap smear test, the patronage of this screening test is still very low in Ghana. Factors influencing the low patronage in Ghana include the marital status of women, their level of satisfaction with healthcare as well as their level of involvement with healthcare. These may be the consequences of a weak health system and the lack of a national policy on cervical cancer screening.
背景
宫颈癌是全球女性第三大常见癌症。在加纳，它一直是、并且仍然是女性癌症死亡的主要原因。尽管通过早期检测和治疗癌前病变可以预防宫颈癌，但加纳妇科诊所的传闻证据表明，大多数患者就诊时已处于疾病晚期。本研究评估了加纳女性的宫颈癌筛查实践。
方法
本研究使用了 2014 年至 2015 年期间在加纳进行的世界卫生组织（WHO）多国家老龄化和成人健康研究（SAGE）第二波的数据。我们采用二元逻辑回归模型分析了 2711 名年龄在 18 岁及以上的女性的数据，以研究与 18 岁及以上女性进行盆腔检查相关的因素。在进行过盆腔检查的女性中，我们应用二元逻辑回归模型分析了作为亚组分析的接受巴氏涂片检查的相关因素。
结果
在所调查的 2711 名 18 岁及以上的女性中，有 225 人（8.3%）曾接受过盆腔检查，仅有 66 人（2.4%）报告曾做过巴氏涂片检查。在接受盆腔检查的女性中，仅有 26.94%的人做过巴氏涂片检查。族裔、婚姻状况、父亲的教育程度和自理能力困难与盆腔检查独立相关。只有年龄和医疗保健参与度与过去 5 年调查时的盆腔检查独立相关。婚姻状况、对医疗保健的满意度和医疗保健参与度与巴氏涂片检查独立相关。
结论
尽管宫颈癌可以通过巴氏涂片检查早期发现癌前病变来预防，但在加纳，这种筛查检查的使用率仍然很低。影响加纳这种低使用率的因素包括女性的婚姻状况、对医疗保健的满意度以及对医疗保健的参与度。这些可能是由于薄弱的卫生系统和缺乏全国性的宫颈癌筛查政策所致。
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