Department of Social Sciences and Health Policy and Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina, USA.
Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, USA.
J Adolesc Young Adult Oncol. 2023 Apr;12(2):159-167. doi: 10.1089/jayao.2022.0013. Epub 2022 Apr 26.
Costs of Papanicolaou (Pap) tests and mammograms are a primary barrier for women aged 18-39 seeking screening and diagnostic services. Race/ethnicity and rural/border resident status compound their risks for delayed diagnosis, possibly resulting in higher mortality. We analyzed cross-sectional data from young adult (YA) women (aged 18-39) from a cancer education and patient navigation (PN) program in rural and border Texas from 2012 to 2016. Descriptive statistics, Chi-square tests, and logistic regressions summarized sociodemographic variables and receipt of PN, Pap tests, and mammograms. The sample consisted of 1181 women aged 31.8 years (standard deviation 5.5) on average. A total of 795 (67.3%) received PN, 494 (41.8%) received a Pap test, and 121 (10.3%) received a mammogram. The YA women attending the program due to cost (odds ratio [OR]: 7.24; confidence interval [CI]: 4.74-11.05) and reporting 1 (OR: 3.84; CI: 2.40-6.14) or 2+ barriers (OR: 6.00; CI: 3.61-9.99) had higher odds of being navigated than those not concerned about cost and not identifying a barrier. The YA women attending due to cost (OR: 2.22, CI: 1.61-3.05) and receiving navigation (OR: 1.92; CI: 1.29-2.84) had higher odds of receiving a Pap test than their counterparts. The majority receiving a mammogram were worried about cost (85.1%); 40.5% had a family history of breast cancer, and a doctor or nurse recommended a mammogram for 15.7%. Detection of cervical and breast cancer in YA women residing in rural and border Texas may be improved with PN to assist with financial barriers to care and service coordination.
巴氏涂片（Pap）检查和乳房 X 光检查的费用是 18-39 岁女性寻求筛查和诊断服务的主要障碍。种族/民族和农村/边境居民身份使她们的诊断延迟风险更高，可能导致死亡率更高。我们分析了 2012 年至 2016 年期间，德克萨斯州农村和边境地区癌症教育和患者导航（PN）计划中青年（18-39 岁）成年女性的横断面数据。描述性统计、卡方检验和逻辑回归总结了社会人口统计学变量以及接受 PN、巴氏涂片检查和乳房 X 光检查的情况。样本由 1181 名年龄为 31.8 岁（标准差为 5.5）的女性组成。共有 795 名（67.3%）接受了 PN，494 名（41.8%）接受了 Pap 检查，121 名（10.3%）接受了乳房 X 光检查。由于费用而参加该项目的年轻女性（优势比 [OR]：7.24；置信区间 [CI]：4.74-11.05）和报告 1 个（OR：3.84；CI：2.40-6.14）或 2 个以上障碍（OR：6.00；CI：3.61-9.99）比不关心费用且未识别障碍的女性更有可能得到导航。由于费用而参加该项目的年轻女性（OR：2.22，CI：1.61-3.05）和接受导航的年轻女性（OR：1.92；CI：1.29-2.84）接受 Pap 检查的可能性更高。大多数接受乳房 X 光检查的女性都担心费用（85.1%）；40.5%有乳腺癌家族史，15.7%的医生或护士建议进行乳房 X 光检查。通过 PN 来帮助解决护理和服务协调方面的经济障碍，可能会改善德克萨斯州农村和边境地区年轻女性的宫颈癌和乳腺癌的检出率。
