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不再推荐用于宫颈筛查:18-24 岁女性对新的国家宫颈筛查计划的看法。

No longer recommended for cervical screening: How women aged 18-24 feel about the renewed National Cervical Screening Program.

机构信息

Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

Aust N Z J Obstet Gynaecol. 2021 Aug;61(4):576-584. doi: 10.1111/ajo.13350. Epub 2021 Apr 16.

Abstract

BACKGROUND

Since December 2017, the Australian National Cervical Screening Program no longer recommends screening for women under 25 years of age.

AIM

To explore the attitudes of women under 25 years toward the changes.

METHODS

In December 2019, women aged 18-24, residing in Australia, were recruited via the social media platform Instagram and Facebook. Descriptive analysis, t-tests, χ tests and multivariable regressions were used to analyse the data.

RESULTS

Five hundred and twelve women completed a cross-sectional web-based survey. Women who were older (22-24: 3.1 vs 18-21: 2.8, P < 0.001), sexually active (3.1 vs 2.7, P = 0.003), vaccinated against human papillomavirus (mean = 3.2 vs 2.7, P = 0.005) or who had screened previously (mean = 3.5 vs 2.8, P < 0.001) had significantly greater knowledge about the current cervical screening practices. Older women (odds ratio (OR) = 0.85, 95% CI 0.80-0.95) or those who had screened previously (OR = 0.51, 95% CI 0.31-0.83) were less positive about the delayed start age of screening and five-yearly screening (OR = 0.54, 95% CI 0.35-0.85). A significant association was determined between being sexually active (χ (4) = 32.71, P < 0.001) and women who had screened previously (χ (4) = 34.43, P < 0.001), with a greater intention to screen in the future. Regarding health information, 64.6% of women had never heard of the 'National Cervical Screening Program' website and 38.9% of the sample (n = 199/512) reported they had 'rarely' noticed any health information regarding cervical screening in the past 12 months.

CONCLUSION

Further work is required to rectify women's knowledge of cervical screening to ensure women under 25 are aware of the screening guidelines and reduce the potential for over-testing and overtreatment in this age group.

摘要

背景

自 2017 年 12 月以来,澳大利亚国家宫颈癌筛查计划不再建议对 25 岁以下的女性进行筛查。

目的

探讨 25 岁以下女性对这些变化的态度。

方法

2019 年 12 月,通过社交媒体平台 Instagram 和 Facebook 招募了年龄在 18-24 岁的澳大利亚女性。采用描述性分析、t 检验、卡方检验和多变量回归分析对数据进行分析。

结果

512 名女性完成了一项横断面网络调查。年龄较大的女性(22-24 岁:3.1;18-21 岁:2.8,P<0.001)、有性行为的女性(3.1;2.7,P=0.003)、接种过 HPV 疫苗的女性(平均值=3.2;2.7,P=0.005)或之前有过筛查的女性(平均值=3.5;2.8,P<0.001)对当前的宫颈癌筛查实践有更深入的了解。年龄较大的女性(比值比(OR)=0.85,95%置信区间 0.80-0.95)或之前有过筛查的女性(OR=0.51,95%置信区间 0.31-0.83)对筛查起始年龄延迟和每 5 年筛查一次的态度较为消极(OR=0.54,95%置信区间 0.35-0.85)。有性行为(卡方(4)=32.71,P<0.001)和之前有过筛查(卡方(4)=34.43,P<0.001)的女性之间存在显著关联,表明她们未来有更大的筛查意愿。关于健康信息,64.6%的女性从未听说过“国家宫颈癌筛查计划”网站,38.9%的样本(n=512/199)报告称,在过去 12 个月中,他们“很少”注意到任何关于宫颈癌筛查的健康信息。

结论

需要进一步开展工作,纠正女性对宫颈癌筛查的认知,确保 25 岁以下的女性了解筛查指南,减少该年龄段过度检测和过度治疗的潜在风险。

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