School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC
School of Population and Public Health (Simkin, Caron, Ogilvie), University of British Columbia; Cancer Control Research (Simkin, van der Hoek, Woods, Peacock, Ogilvie), BC Cancer; Women's Health Research Institute (Simkin, Smith, Caird, Ogilvie); Cancer Control Research (Smith, van Niekerk, Caron), BC Cancer, Vancouver, BC; Faculty of Health Sciences (Caird, Woods, Peacock), Simon Fraser University, Burnaby, BC; School of Nursing (Dearden), University of British Columbia; Canadian Centre for Applied Research in Cancer Control (van der Hoek, Peacock); Centre for Excellence in Indigenous Health (Caron), University of British Columbia, Vancouver, BC.
CMAJ Open. 2021 Apr 22;9(2):E424-E432. doi: 10.9778/cmajo.20200139. Print 2021 Apr-Jun.
Although cancer screening has led to reductions in the incidence of invasive cervical cancer (ICC) across Canada, benefits of prevention efforts are not equitably distributed. This study investigated the sociodemographic characteristics of women with ICC in British Columbia compared with the general female population in the province.
In this descriptive study, data of individuals 18 years and older diagnosed with ICC between 2004 and 2013 were obtained from the BC Cancer Registry. Self-reported sociodemographic characteristics were derived from standardized health assessment forms (HAFs) completed upon admission in the BC Cancer Registry. Standardized ratios (SRs) were derived by dividing observed and age-adjusted expected counts by ethnicity or race, language, and marital, smoking and urban-rural status. Differences between observed and expected counts were tested using χ goodness-of-fit tests. General population data were derived from the 2006 Census, 2011 National Household Survey and 2011/12 Canadian Community Health Survey.
Of 1705 total cases of ICC, 1315 were referred to BC Cancer (77.1%). Of those who were referred, 1215 (92.4%) completed HAFs. Among Indigenous women, more cases were observed ( = 85) than expected ( = 39; SR 2.16, 95% confidence interval [CI] 2.15-2.18). Among visible minorities, observed cases ( = 320) were higher than expected ( = 253; 95% CI 1.26-1.26). Elevated SRs were observed among women who self-identified as Korean (SR 1.78, 95% CI 1.76-1.80), Japanese (SR 1.77, 95% CI 1.74-1.79) and Filipino (SR 1.60, 95% CI 1.58-1.62); lower SRs were observed among South Asian women (SR 0.63, 95% CI 0.62-0.63). Elevated SRs were observed among current smokers (SR 1.34, 95% CI 1.33-1.34) and women living in rural-hub (SR 1.29, 95% CI 1.28-1.31) and rural or remote (SR 2.62, 95% CI 2.61-2.64) areas; the SR was lower among married women (SR 0.90, 95% CI 0.90-0.90).
Women who self-identified as visible minorities, Indigenous, current smokers, nonmarried and from rural areas were overrepresented among women with ICC. Efforts are needed to address inequities to ensure all women benefit from cervical cancer prevention.
尽管癌症筛查已在加拿大范围内降低了浸润性宫颈癌（ICC）的发病率，但预防措施的益处并未公平分配。本研究比较了不列颠哥伦比亚省 ICC 患者与该省普通女性人群的社会人口统计学特征。
在这项描述性研究中，从不列颠哥伦比亚癌症登记处获得了 2004 年至 2013 年间诊断为 ICC 的 18 岁及以上个体的数据。通过不列颠哥伦比亚癌症登记处入院时填写的标准化健康评估表（HAF）获得自我报告的社会人口统计学特征。通过将观察到的和年龄调整后的预期计数除以族裔或种族、语言以及婚姻、吸烟和城乡状况，得出标准化比率（SR）。使用 χ 拟合优度检验测试观察到的计数与预期计数之间的差异。总人口数据来自 2006 年人口普查、2011 年全国住户调查和 2011/12 年加拿大社区健康调查。
在总共 1705 例 ICC 病例中，有 1315 例被转诊至不列颠哥伦比亚癌症（77.1%）。在转诊的病例中，有 1215 例（92.4%）完成了 HAF。在原住民妇女中，观察到的病例（ = 85）多于预期的病例（ = 39；SR 2.16，95%置信区间 [CI] 2.15-2.18）。在少数族裔妇女中，观察到的病例（ = 320）多于预期的病例（ = 253；95%CI 1.26-1.26）。自我认同为韩国人（SR 1.78，95%CI 1.76-1.80）、日本人（SR 1.77，95%CI 1.74-1.79）和菲律宾人（SR 1.60，95%CI 1.58-1.62）的妇女中观察到的 SR 升高；南亚妇女的 SR 较低（SR 0.63，95%CI 0.62-0.63）。当前吸烟者（SR 1.34，95%CI 1.33-1.34）和居住在农村中心（SR 1.29，95%CI 1.28-1.31）和农村或偏远地区（SR 2.62，95%CI 2.61-2.64）的妇女中观察到的 SR 升高；已婚妇女的 SR 较低（SR 0.90，95%CI 0.90-0.90）。
自我认同为少数族裔、原住民、当前吸烟者、未婚和来自农村地区的妇女在 ICC 妇女中占比过高。需要努力解决不平等问题，以确保所有妇女都能从宫颈癌预防中受益。
