Department of Medicine, University of Washington, Seattle, WA, USA.
Department of Biostatistics, University of Washington, Seattle, WA, USA.
Subst Abus. 2022;43(1):925-931. doi: 10.1080/08897077.2021.2010257.
: Substance use-related diagnoses are common and associated with poor health outcomes. The objective of this analysis was to compare rates of cervical cancer screening, screening abnormalities, and follow-up care in women with and without a substance use-related diagnosis seen for primary care between January 1, 2016 and December 31, 2019 in the University of Washington healthcare system. : This study included women aged 21-65 years of age who had at least one outpatient visit between January 1, 2016 and December 31, 2019 within one of 45 primary care or women's health clinics in the academic healthcare system. Exposure status was defined using ICD10 codes for substance-use related diagnoses or no substance-use related diagnoses. Only first cervical cancer screening was included. Generalized linear models with a binomial family and log link were used to estimate risk ratios. : 3845 women had a substance use-related diagnosis and 89214 did not. Women with a substance use-related diagnosis were less likely to be screened for cervical cancer (44%, 1675/3845) compared to women without a substance use-related diagnosis (49%, 43338/89214; relative risk [RR] 0.90, 95% CI 0.86-0.93). Women with a substance use-related diagnosis were also more likely to have an abnormal screening result (18%, 304/1675) compared to women without a substance use-related diagnosis (10%, 4528/43338; RR 1.74, 95% CI 1.56-1.93). Follow-up for abnormal screens did not differ significantly between groups (24 vs 25%; RR 0.80, 95% CI 0.55-1.17). : To combat disparities in cervical cancer screening for women with substance use-related diagnoses, public health efforts should expand access to screening where women with substance use-related diagnoses are seen, including acute care, inpatient hospitalizations, and addiction treatment settings.
：物质使用相关诊断很常见，并且与健康状况不佳有关。本分析的目的是比较 2016 年 1 月 1 日至 2019 年 12 月 31 日期间在华盛顿大学医疗保健系统中因初级保健而就诊的有和没有物质使用相关诊断的女性的宫颈癌筛查率、筛查异常和随访护理。：本研究纳入了年龄在 21-65 岁之间的女性，她们在 2016 年 1 月 1 日至 2019 年 12 月 31 日期间至少有一次在学术医疗保健系统中的 45 个初级保健或妇女健康诊所中的一个进行了门诊就诊。暴露状态是使用 ICD10 代码来定义的，用于物质使用相关诊断或没有物质使用相关诊断。仅包括首次宫颈癌筛查。使用二项式家族和对数链接的广义线性模型来估计风险比。：3845 名女性有物质使用相关诊断，89214 名女性没有。与没有物质使用相关诊断的女性相比，有物质使用相关诊断的女性进行宫颈癌筛查的可能性较低（44%，1675/3845）（相对风险 [RR]0.90，95%CI0.86-0.93）。有物质使用相关诊断的女性也更有可能出现异常筛查结果（18%，304/1675），而没有物质使用相关诊断的女性则为 10%（4528/43338；RR1.74，95%CI1.56-1.93）。异常筛查的随访在两组之间没有显著差异（24%比 25%；RR0.80，95%CI0.55-1.17）。：为了消除物质使用相关诊断女性宫颈癌筛查的差异，公共卫生工作应扩大有物质使用相关诊断的女性接受筛查的机会，包括急性护理、住院治疗和成瘾治疗场所。
