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从宫颈癌幸存者身上学习:对美国女性宫颈癌筛查障碍和促进因素的考察。

Learning From Cervical Cancer Survivors: An Examination of Barriers and Facilitators to Cervical Cancer Screening Among Women in the United States.

机构信息

Centers for Disease Control and Prevention, Atlanta, GA, USA.

Battelle, Seattle, WA, USA.

出版信息

J Prim Care Community Health. 2021 Jan-Dec;12:21501327211041862. doi: 10.1177/21501327211041862.

Abstract

BACKGROUND

Screening and timely follow-up have lowered cervical cancer incidence in the US; however, screening coverage, incidence, and death rates have remained fairly stable in recent years. Studies suggest that half of women diagnosed with cervical cancer don't receive appropriate screening prior to diagnosis; cervical cancer survivors can provide crucial insight into barriers and facilitators to screening.

METHODS

Participants were cervical cancer survivors ≥21 years, identified through population-based central cancer registries (CR) in 3 US states or a social network (SN), Cervivor. CR participants completed a mailed survey on screening history, barriers, and facilitators to screening and sociodemographic data. SN participants completed the same survey online.

RESULTS

CR participants (N = 480) were older, with a lower proportion of non-Hispanic white, married, and insured women compared to SN participants (N = 148). Fifty percent of CR and 79% of SN participants were screened 5 years prior to their diagnoses. Of those screened, 28% in both groups reported not following-up on abnormal results. For both groups, the most frequently identified screening barrier was that participants never imagined they would develop cervical cancer (percent agree CR = 76%; SN = 86%), and the facilitator was wanting to take care of their bodies (CR = 95%; SN = 94%).

CONCLUSION

Addressing key barriers to obtaining screening and timely follow-up related to lack of knowledge of cervical cancer risk and screening tests and addressing insurance coverage in the design or modification of interventions may increase cervical cancer screening and lower cervical cancer incidence in the US.

摘要

背景

在美国,通过筛查和及时随访,宫颈癌的发病率有所降低;然而,近年来筛查覆盖率、发病率和死亡率基本保持稳定。研究表明,一半被诊断患有宫颈癌的女性在诊断前没有接受过适当的筛查;宫颈癌幸存者可以为筛查的障碍和促进因素提供重要的见解。

方法

参与者为年龄≥21 岁的宫颈癌幸存者,通过美国 3 个州的基于人群的癌症登记处(CR)或社交网络(SN)Cervivor 确定。CR 参与者通过邮寄问卷完成关于筛查史、筛查障碍和促进因素以及社会人口统计学数据的调查。SN 参与者在线完成相同的调查。

结果

CR 参与者(N=480)年龄较大,与 SN 参与者(N=148)相比,非西班牙裔白人、已婚和有保险的女性比例较低。50%的 CR 参与者和 79%的 SN 参与者在诊断前 5 年接受过筛查。在接受筛查的人群中,有 28%的 CR 参与者和 79%的 SN 参与者报告说他们没有对异常结果进行随访。对于两组参与者来说,最常见的筛查障碍是他们从未想象过自己会患上宫颈癌(CR 组参与者同意该观点的比例为 76%;SN 组为 86%),促进因素是想要照顾好自己的身体(CR 组参与者同意该观点的比例为 95%;SN 组为 94%)。

结论

在设计或修改干预措施时,针对与缺乏宫颈癌风险和筛查检测知识相关的获得筛查和及时随访的关键障碍,并解决保险覆盖范围问题,可能会增加美国的宫颈癌筛查率,降低宫颈癌发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489e/8424614/c1a1f00ce19d/10.1177_21501327211041862-fig1.jpg

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