Boitano Teresa K L, Ketch Peter, Maier Julia G, Nguyen Christine T, Huh Warner K, Michael Straughn J, Scarinci Isabel C
Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, United States.
Department of Obstetrics and Gynecology, University of Alabama at Birmingham, AL, United States.
Gynecol Oncol Rep. 2022 Jul 16;42:101041. doi: 10.1016/j.gore.2022.101041. eCollection 2022 Aug.
To determine whether race and ethnicity impacts patient adherence to follow-up for colposcopy after abnormal cervical cancer screening.
This retrospective chart review included women that were randomly selected from patients presenting to our colposcopy clinic from 1/2019 to 12/2019. Inclusion criteria were females age ≥21 years-old and appropriate referral for colposcopy. Patients were grouped into three categories: (1) ADHERENT to follow-up if they came to their first scheduled appointment; (2) DELAYED if they presented more than three months from their original referral (usually missing 1-3 appointments); and (3) NOT ADHERENT if they did not show for their appointment after referral. Analysis was performed using SPSS v.26.
284 women met inclusion criteria for the study. The majority of women were Black (65.2 %) followed by non-Hispanic Whites (20.0 %) and Latinx (14.8 %). Overall, 39.1 % were ADHERENT, 18.6 % were DELAYED, and 42.3 % were NOT ADHERENT. When compared with non-Hispanic White women, there was a significant difference between race/ethnicity and timing of follow-up (p = 0.03). Blacks were more likely to be NOT ADHERENT (45.9 %; p = 0.03), and Latinx and Blacks were the most likely to be DELAYED (35.7 % and 21.1 %; p = 0.03). Private insurance patients were more likely to be ADHERENT for care compared with un-/underinsured patients (78.9 vs 27.8 %, p = 0.0001).
There is inadequate follow-up after abnormal cervical cancer screening across all races/ethnicities; however, lack of adherence is higher in Black patients. Moreover, 25% of Hispanic and Black women present in a delayed fashion. Culturally relevant assessments and interventions are needed to understand and address these gaps.
确定种族和族裔是否会影响宫颈癌筛查异常后患者接受阴道镜检查随访的依从性。
这项回顾性病历审查纳入了从2019年1月至2019年12月到我们阴道镜诊所就诊的患者中随机选取的女性。纳入标准为年龄≥21岁的女性且有进行阴道镜检查的适当转诊。患者被分为三类：（1）如果她们按时前来首次预约就诊，则为依从随访；（2）如果她们在原转诊后三个月以上才前来就诊（通常错过1 - 3次预约），则为延迟就诊；（3）如果她们在转诊后未按预约就诊，则为不依从。使用SPSS v.26进行分析。
284名女性符合该研究的纳入标准。大多数女性为黑人（65.2%），其次是非西班牙裔白人（20.0%）和拉丁裔（14.8%）。总体而言，39.1%为依从，18.6%为延迟，42.3%为不依从。与非西班牙裔白人女性相比，种族/族裔与随访时间存在显著差异（p = 0.03）。黑人更有可能不依从（45.9%；p = 0.03），拉丁裔和黑人最有可能延迟就诊（35.7%和21.1%；p = 0.03）。与未参保/参保不足的患者相比，有私人保险的患者更有可能依从治疗（78.9%对27.8%，p = 0.0001）。
所有种族/族裔在宫颈癌筛查异常后的随访均不足；然而，黑人患者的不依从率更高。此外，25%的西班牙裔和黑人女性就诊延迟。需要进行与文化相关的评估和干预，以了解并解决这些差距。
