Mitoma Tomohiro, Maki Jota, Ooba Hikaru, Ogawa Chikako, Masuyama Hisashi, Tabuchi Takahiro
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Department of Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan.
Int J Gen Med. 2024 Feb 13;17:541-551. doi: 10.2147/IJGM.S453675. eCollection 2024.
PURPOSE: Among the Organisation for Economic Co-operation and Development countries, Japan has one of the lowest cervical cancer screening coverages. Cancer screening coverage has worsened due to the coronavirus disease of 2019 (COVID-19) pandemic. This study investigated the relationship between socioeconomic background, COVID-19 infection history and vaccine status, and regular cervical cancer screening (CCS) during the two years of the COVID-19 era in Japan. PATIENTS AND METHODS: We used data from the Japan COVID-19 and Society Internet Survey, a nationwide, Internet-based, self-report cohort observational study conducted in 2022. The outcome variable was identified by asking whether the participants had undergone CCS within the last two years. Cervical cytology was performed in Japan by brushing the external cervical os. This study used multivariate log-binomial regression models to evaluate inequalities during regular checkups for CCS. Adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs) were estimated to incorporate the socioeconomic background variables. RESULTS: Of the 12,066 participants, 5597 (46.4%) had undergone regular CCS for over two years. The prevalence ratio (PR) of patients who underwent CCS was 0.70 for those in their 20s and 0.78 for those in their 60s, compared to those in their 40s. Socioeconomic inequities were found in the following groups: unemployed/student, unmarried, high school graduate or lower, and household income below 4 million Yen. Our final multivariate analysis revealed that participants who were in their 20s or 60s, had a household income below 4 million Yen, were unmarried, had no annual health check-ups, and were unvaccinated with COVID-19 were at a higher risk of not undergoing CCS. CONCLUSION: The relationship between socioeconomic inequality and CCS hesitancy is prevalent among younger participants. The CCS coverage in Japan during the COVID-19 pandemic year (2020-2022) was not low compared with the pre-pandemic era.
目的:在经济合作与发展组织国家中,日本的宫颈癌筛查覆盖率处于最低水平之一。由于2019年冠状病毒病(COVID-19)大流行,癌症筛查覆盖率有所下降。本研究调查了日本COVID-19时代两年间社会经济背景、COVID-19感染史和疫苗接种状况与定期宫颈癌筛查(CCS)之间的关系。 患者与方法:我们使用了2022年开展的日本COVID-19与社会互联网调查的数据,这是一项全国性的基于互联网的自我报告队列观察性研究。通过询问参与者在过去两年内是否接受过CCS来确定结果变量。在日本,宫颈细胞学检查是通过刷取宫颈外口进行的。本研究使用多变量对数二项回归模型来评估CCS定期检查期间的不平等情况。估计了调整患病率比(APR)及其95%置信区间(CI),以纳入社会经济背景变量。 结果:在12,066名参与者中,5597名(46.4%)进行定期CCS超过两年。与40多岁的参与者相比,20多岁的参与者接受CCS的患病率比(PR)为0.70,60多岁的参与者为0.78。在以下人群中发现了社会经济不平等:失业/学生、未婚、高中及以下学历、家庭收入低于400万日元。我们的最终多变量分析显示,20多岁或60多岁、家庭收入低于400万日元、未婚、没有年度健康检查且未接种COVID-19疫苗的参与者未接受CCS的风险更高。 结论:社会经济不平等与CCS犹豫之间的关系在年轻参与者中普遍存在。与大流行前时代相比,日本在COVID-19大流行年份(2020 - 2022年)的CCS覆盖率并不低。
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