Najem G R, Batuman F, Smith A M
Department of Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103-2714, USA.
Am J Prev Med. 1996 Nov-Dec;12(6):482-6.
The English medical literature for the past decade lacks any reports on Papanicolaou (Pap) test status among inner-city adolescent girls. Our objectives were (1) to assess the pattern of Pap test status among inner-city adolescent girls and (2) to ascertain the association of the Pap test status with their knowledge, beliefs, and behaviors.
All 3,980 inner-city senior high school adolescent female students in two cities in New Jersey were included in the survey. Response rate was 84%; 89% of respondents were minority adolescents.
The factors that significantly increased the probability of obtaining a Pap smear were physician recommendation for Pap test, being knowledgeable of Pap test, awareness that other family members had obtained Pap tests, family income and parents' education levels. The age of initiation of first Pap test almost always was before 18 years of age; 13% of sexually active girls were smokers. The major barriers for never having had a Pap test were lack of physician's recommendation, ignorance about the Pap test, cost of the test, lack of information on how and where to obtain it, belief that they were not at risk for cancer, and embarrassment over requesting the test.
Inner-city predominantly minority adolescent girls who have considerable sexual activity, multiple sex partners, initiation of intercourse at an early age, and smoking are at high risk for cervical cancer. It makes sense to initiate Pap screening for such high-risk adolescents. Individualized Pap test educational intervention programs adopted to the adolescents' barriers to undergoing Pap testing and physicians' recommendations for this preventive care are needed to encourage high-risk adolescent girls to undergo regular Pap tests and appropriate follow-up.
过去十年的英文医学文献中缺乏关于市中心城区青春期少女巴氏涂片检查情况的报告。我们的目标是：（1）评估市中心城区青春期少女的巴氏涂片检查情况模式；（2）确定巴氏涂片检查情况与其知识、信念和行为之间的关联。
新泽西州两个城市的所有3980名市中心城区高中青春期女学生都被纳入调查。回复率为84%；89%的受访者为少数族裔青少年。
显著增加进行巴氏涂片检查可能性的因素包括医生建议进行巴氏检查、了解巴氏检查、知晓其他家庭成员已进行巴氏检查、家庭收入和父母教育水平。首次进行巴氏检查的年龄几乎总是在18岁之前；13%有性行为的女孩吸烟。从未进行过巴氏检查的主要障碍包括缺乏医生建议、对巴氏检查无知、检查费用、缺乏关于如何以及何处进行检查的信息、认为自己没有患癌风险以及因要求进行检查而感到尴尬。
市中心城区以少数族裔为主的青春期少女，有大量性活动、多个性伴侣、过早开始性行为且吸烟，患宫颈癌的风险很高。对这类高危青少年开展巴氏涂片筛查是有意义的。需要针对青少年进行巴氏检查的障碍以及医生对这种预防保健的建议，制定个性化的巴氏检查教育干预项目，以鼓励高危青春期少女定期进行巴氏检查及适当的后续检查。
