Swaddiwudhipong W, Chaovakiratipong C, Nguntra P, Mahasakpan P, Lerdlukanavonge P, Koonchote S
Department of Community and Social Medicine, Mae Sot General Hospital, Thailand.
Int J Epidemiol. 1995 Jun;24(3):493-8. doi: 10.1093/ije/24.3.493.
A large proportion of women in most developing countries, particularly in rural areas, have never had cervical cancer screening. This paper reports the effect of a cervical cancer screening programme using a mobile unit on changes in knowledge and use of Papanicolaou (Pap) smear screening among rural Thai women.
Health education and collection of Pap smears were carried out by the mobile unit throughout the 54 rural villages in Mae Sot District, Tak Province, between January and February 1993. To determine the extent of changes, we compared the results of two interview surveys of women 18-65 years old in the villages selected by systematic sampling for each survey, first in January 1991 and then in January 1994.
A total of 1603 and 1369 women participated in each survey respectively. The proportion of women who knew of the Pap smear test increased from 20.8% in the first survey sample to 57.3% in the second survey sample. The proportion of those who had even been screened increased from 19.9% in the first survey sample to 58.1% in the second survey sample. These increases were observed solely among ever-married women and there were no significant changes among single women, most of whom remained unscreened. Of ever-married women, the magnitude of increase was highest in the age group 25-34 years, and declined with increasing age.
Greater efforts should be made to encourage the use of screening among the older women. The use of mobile units may be helpful for rapid achievement of higher screening coverage in rural areas, where existing screening services cannot effectively cover the female population at risk.
在大多数发展中国家，很大一部分女性，尤其是农村地区的女性，从未接受过宫颈癌筛查。本文报告了一项使用移动筛查单位开展的宫颈癌筛查项目对泰国农村女性巴氏涂片筛查知识知晓率及筛查行为改变的影响。
1993年1月至2月期间，移动筛查单位在泰国北碧府湄索县的54个乡村开展了健康教育及巴氏涂片采集工作。为确定变化程度，我们比较了对18至65岁女性进行的两次访谈调查结果。每次调查均采用系统抽样法从乡村中选取样本，第一次调查于1991年1月进行，第二次调查于1994年1月进行。
每次调查分别共有1603名和1369名女性参与。知晓巴氏涂片检查的女性比例从第一次调查样本中的20.8%增至第二次调查样本中的57.3%。接受过筛查的女性比例从第一次调查样本中的19.9%增至第二次调查样本中的58.1%。这些增长仅在已婚女性中观察到，单身女性中无显著变化，她们中的大多数仍未接受筛查。在已婚女性中，25至34岁年龄组的增长幅度最大，并随年龄增长而下降。
应加大力度鼓励老年女性接受筛查。在现有筛查服务无法有效覆盖高危女性人群的农村地区，使用移动筛查单位可能有助于快速提高筛查覆盖率。
