Mandelblatt J, Traxler M, Lakin P, Kanetsky P, Kao R
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Prev Med. 1993 Jan;22(1):20-33. doi: 10.1006/pmed.1993.1002.
Factors associated with participation in breast and cervix cancer screening among elderly black women of low socioeconomic status were determined.
Data from a baseline cross-sectional random survey were used together with data on whether screening was subsequently completed or refused. The subjects were a random sample of women attending an urban public hospital primary care clinic for routine medical care with a birth year of 1924 or earlier.
Among the 271 women in the study group, 70% completed screening. Stated intent was the strongest predictor of participation; women who intended to have both mammography and Pap testing were 2.7 times more likely to participate than those who intended to have neither test (95% confidence interval 1.4, 4.9; P < 0.01), controlling for age, insurance status, and level of chronic illness. Women who had more than three chronic illnesses were twice as likely to participate than those with three or fewer illnesses (95% confidence interval 1.1, 3.4 P < 0.02), controlling for the remaining variables. Other variables, including age, history of a recent screening examination, attitudes, or knowledge, were not related to participation. Stated intent was the only variable that predicted compliance with both mammography and Pap smear completion in separate regression models for the individual tests.
A high proportion of elderly, socioeconomically disadvantaged black women will participate in cancer screening when it is offered in a primary care setting. Further research on behavioral intentions should be conducted to refine interventions designed to enhance the use of early cancer detection among vulnerable population groups.
确定了与社会经济地位较低的老年黑人女性参与乳腺癌和宫颈癌筛查相关的因素。
将基线横断面随机调查的数据与后续筛查是否完成或被拒绝的数据相结合。研究对象是在城市公立医院初级保健诊所接受常规医疗护理且出生年份为1924年或更早的女性随机样本。
在研究组的271名女性中，70%完成了筛查。明确的意愿是参与筛查的最强预测因素；打算同时进行乳房X光检查和巴氏试验的女性参与筛查的可能性是那些既不打算进行乳房X光检查也不打算进行巴氏试验的女性的2.7倍（95%置信区间1.4, 4.9；P < 0.01），在控制年龄、保险状况和慢性病水平后。患有三种以上慢性病的女性参与筛查的可能性是患有三种或更少慢性病的女性的两倍（95%置信区间1.1, 3.4；P < 0.02），在控制其余变量后。其他变量，包括年龄、近期筛查检查史、态度或知识，与参与筛查无关。在针对各项检查的单独回归模型中，明确的意愿是唯一预测同时完成乳房X光检查和巴氏涂片检查的变量。
在初级保健环境中提供癌症筛查时，很大一部分社会经济处于劣势的老年黑人女性会参与。应进一步开展关于行为意图的研究，以完善旨在增加弱势群体早期癌症检测使用率的干预措施。
