Luque John S, Maupin Jonathan, Ferris Daron G
Institute of Public Health, Florida A&M University, Tallahassee, FL, USA.
School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.
Cancer Health Disparities. 2019;3:e1-e16. Epub 2019 Aug 18.
Cervical cancer remains one of the major cancers affecting women from developing countries, especially those from socioeconomically disadvantage backgrounds. In the US, Hispanic immigrant women experience restricted access to health care and higher incidence rates of cervical cancer compared to the non-Hispanic white population. Knowledge of cervical cancer risk factors and symptoms is associated with greater interest in participating in regular cervical cancer screening. To explore knowledge and beliefs about cervical cancer, survey questionnaires were administered to Mexican immigrant women in southeast Georgia, US and to mestizo women - primarily Quechua language dominant speakers - in Cusco, Peru. As part of these survey studies, there was a list of 32 items asking participants to agree or disagree with whether certain symptoms or risk factors could cause cervical cancer and a pile sort of 15 of the most salient items. Cultural consensus analysis was used to calculate overall agreement with a cultural model of cervical cancer risk factor knowledge in each sample independently. For the Georgia sample, there was marginal consensus, but for the Peru sample, there was no consensus. Analysis of cultural competence values and residual agreement show significant differences across education in the Georgia study, with a positive correlation between education and cultural competence (r=0.50, p=0.001), but not in the Peru study. Likewise, the results of the pile sort data exhibited consensus for the Georgia sample for the cervical cancer risk factors, but not for the Peru sample. The lack of consensus among the Peru sample on either task suggests little widespread knowledge on risk factors of cervical cancer. Additional analyses related to factors associated with screening behaviors from the cultural cancer screening scale indicated more pronounced fatalistic beliefs and catastrophic disease expectations about cervical cancer among the Peruvian women compared to the Mexican immigrant women.
宫颈癌仍然是影响发展中国家女性的主要癌症之一，尤其是那些来自社会经济背景不利的女性。在美国，与非西班牙裔白人相比，西班牙裔移民女性获得医疗保健的机会有限，宫颈癌发病率更高。了解宫颈癌的风险因素和症状与更积极参与定期宫颈癌筛查的意愿相关。为了探究对宫颈癌的认知和看法，研究人员对美国佐治亚州东南部的墨西哥移民女性以及秘鲁库斯科的混血女性（主要以克丘亚语为主要语言）进行了问卷调查。作为这些调查研究的一部分，有一份包含32个条目的清单，要求参与者对某些症状或风险因素是否会导致宫颈癌表示同意或不同意，并对15个最突出的条目进行排序。文化共识分析被用来分别计算每个样本中与宫颈癌风险因素知识文化模型的总体一致性。对于佐治亚州的样本，存在微弱的共识，但对于秘鲁的样本，则不存在共识。对文化能力值和剩余一致性的分析表明，在佐治亚州的研究中，不同教育程度之间存在显著差异，教育程度与文化能力呈正相关（r = 0.50，p = 0.001），但在秘鲁的研究中并非如此。同样，排序数据的结果显示，佐治亚州样本在宫颈癌风险因素方面达成了共识，但秘鲁样本没有。秘鲁样本在任何一项任务上都缺乏共识，这表明对宫颈癌风险因素的普遍了解很少。与文化癌症筛查量表中与筛查行为相关的因素的其他分析表明，与墨西哥移民女性相比，秘鲁女性对宫颈癌有更明显的宿命论信念和对灾难性疾病的预期。
