Hubbell F A, Chavez L R, Mishra S I, Valdez R B
Center for Health Policy and Research, University of California, Irvine, USA.
Arch Intern Med. 1996 Nov 11;156(20):2353-8.
Latinas use cervical cancer prevention services less often than Anglo women.
To assess whether beliefs about cervical cancer influence the use of Papanicolaou (Pap) smears among Latinas and Anglo women in Orange County, California.
We conducted a telephone survey using the computer-assisted telephone interview system, randomdigit dialing, and an instrument adapted from national surveys and a previous ethnographic study.
Participants included 1225 noninstitutionalized Spanish- or English-speaking respondents 18 years or older-803 Latinas (533 immigrants and 270 US born) and 422 Anglo women. Latina immigrants were more likely than US-born Latinas or Anglo women to believe that a variety of behaviors were risk factors for this disease. These behaviors included medically accepted risk factors such as early initiation of sexual intercourse (53% vs 41% vs 39%; P < .01) as well as unaccepted factors such as having sex during menstruation (56% vs 10% vs 3%; P < .01). Logistic regression analysis revealed that Latinas who held such beliefs were significantly less likely than others to report receiving a Pap smear within the past 3 years. Other independent predictors of Pap smear use included health insurance status, martial status, and acculturation.
Latinas have culturally based beliefs about cervical cancer that reflect the moral framework within which they interpret diseases and that may influence their use of Pap smears. These beliefs are most prevalent among Latina immigrants. Because the known risk factors for cervical cancer are primarily related to sexual activities and because such activities are private and sensitive for many Latinas, physicians should be cautious when counseling these patients about the cause of this disease. Indeed, stressing the sexual transmission of cervical cancer could even discourage Latina immigrants from obtaining appropriate Pap smear screening.
拉丁裔女性比盎格鲁女性更少使用宫颈癌预防服务。
评估关于宫颈癌的信念是否会影响加利福尼亚州奥兰治县拉丁裔和盎格鲁女性对巴氏涂片检查的使用。
我们使用计算机辅助电话访谈系统、随机数字拨号以及从全国性调查和先前的人种学研究改编而来的工具进行了一项电话调查。
参与者包括1225名18岁及以上的非机构化讲西班牙语或英语的受访者——803名拉丁裔女性（533名移民和270名美国出生）和422名盎格鲁女性。拉丁裔移民比美国出生的拉丁裔女性或盎格鲁女性更有可能认为多种行为是这种疾病的风险因素。这些行为包括医学上认可的风险因素，如过早开始性行为（53%对41%对39%；P<.01）以及不被认可的因素，如在月经期间发生性行为（56%对10%对3%；P<.01）。逻辑回归分析显示，持有这些信念的拉丁裔女性在过去3年内进行巴氏涂片检查的可能性明显低于其他人。巴氏涂片检查使用的其他独立预测因素包括健康保险状况、婚姻状况和文化适应程度。
拉丁裔女性对宫颈癌有基于文化的信念，这些信念反映了她们解释疾病的道德框架，并且可能影响她们对巴氏涂片检查的使用。这些信念在拉丁裔移民中最为普遍。由于已知的宫颈癌风险因素主要与性活动有关，并且由于此类活动对许多拉丁裔女性来说是私密和敏感的，医生在为这些患者提供关于这种疾病病因的咨询时应谨慎。事实上，强调宫颈癌的性传播甚至可能会使拉丁裔移民不愿接受适当的巴氏涂片筛查。
