Do personalised letters in Vietnamese increase cervical cancer screening among Vietnamese women?

In Australia, Vietnamese women are at greater risk of cervical cancer than other Australian women. To increase their participation in cervical screening, the Vietnamese community was exposed to a media campaign about the advantages of cervical smear screening which was delivered in Vietnamese through Vietnamese newspapers and radio. In addition, 689 Vietnamese (18–67 years) were selected from the electoral roll. They were randomly assigned to either receive a personal letter written in Vietnamese promoting cervical screening, or not. We report on the effect of the letter on smear rates.
Being randomised to be sent such a letter was not associated with any increase in screening (relative rate of appropriate screening in the intervention versus the control group was 0.85, 95% Cl 0.55–1.3). It is important to carefully evaluate untested health promotion interventions.     

Factors associated with cervical cancer screening in women covered by national health insurance

BACKGROUND: The aims of our study were to examine the factors associated with cervical screening in women whose tests are supported by a national health insurance scheme, the Mutuelle Générale de l'Education Nationale. METHODS: A self-administered postal questionnaire was sent to a random sample of 10,000 adults aged 20 to 60 years old living in France and insured with the Mutuelle Générale de l'Education Nationale. Response rate was 66.5% (N=6,518). RESULTS: Of the 3,741 women aged 20 to 60 years old, 88.5% have had at least one cervical smear. Mean age for the first cervical smear was 29.3 years (95% CI: 29.0-29.6). Preventive practices (mammogram, cervical smear and fecal occult-blood testing) were strongly related. The predictive factors for cervical smear during the past three years included: age between 30 and 49 years, marital status (married, separated or divorced), the socioeconomic status (unskilled workers reported cervical smears less often than women from other socioeconomic status). Consulting a gynaecologist in the past twelve months increased 9-fold the probability of having a cervical smear and 2-fold when consulting a general practitioner compared to women who consulted neither a gynecologist nor a general practitioner. CONCLUSIONS: In a population whose tests were supported by a national health scheme, the socioeconomic status was one of the determinants of Pap smear.     

Factors associated with the use of breast and cervical cancer screening services among Chinese women in Hong Kong

We conducted a cross-sectional survey using a self-administered questionnaire among attendees of a well women clinic in Hong Kong during June and July 1998. The study aimed to examine the factors associated with the past and future use of screening services among Chinese women in Hong Kong and their perception of service providers. Of the 430 respondents (64% response rate), 87% were aged 31-50 y, 85% married, 93% attained education to upper secondary school level, and 96% were non-smokers. Nearly all respondents (99%) reported having sexual experience and most of them (87%) had such experience with only one partner; 59% reported having a pap-smear test, 28% a mammogram and 44% a breast self-examination. Women who were health conscious (ate a lower fat diet and performed regular exercise) were more likely to have used the screening service (mammogram and pap-smear test) and performed breast self-examination. Staff manner, privacy and cost were the most common contributing factors for respondent's desire for future use of the screening service. Respondents showed a preference for doctors (70%) over nurses (30%), and females (80%) over males (20%) as their service providers. The findings suggest the need to disseminate appropriate information on screening services among the public to dispel misconceptions about the preference for doctors over nurses and females over males. Improving clinician- and other staff-patient communication would be important for breast and cervical screening programs in Hong Kong.     

Factors associated with inadequate cervical cancer screening among lower income primary care patients

This study identified factors associated with cervical cancer screening patterns among lower income primary care patients. One hundred forty-one women completed a self-administered questionnaire before their medical visit. The results indicated that 71 percent had a Papanicolaou (Pap) test in the past year, 14 percent had one between 1 and 3 years ago, and 15 percent had not had a Pap test for 3 or more years. Advanced age was associated with a reduced likelihood of adequate screening; 21 percent of women aged 50-64 years and 39 percent of those aged 65 years and older had not had a Pap test in the past 3 years. Factors positively associated with screening included perceived susceptibility to cervical cancer and the belief in the efficacy of Pap tests and benefits of screening. Fear of finding cancer was a significant barrier to cervical screening in this population. Of those women who had not been screened adequately, 58 percent were interested in obtaining Pap tests in the primary care setting. The implications for promoting cervical cancer screening in primary care practices are discussed.     

基于健康信念模式的上海市社区妇女宫颈癌筛查行为影响因素研究

目的 基于健康信念模式,初步探索社区妇女宫颈癌筛查行为的影响因素,以期提出针对筛查需方角度的建议,为优化宫颈癌筛查工作提供参考。方法 对上海市2个区自愿参加宫颈癌筛查的社区女性487例进行问卷调查。应用x²检验与t检验进行不同筛查行为影响因素的比较,采用logistic回归评估各因素对筛查行为的影响。结果 41.7%（203例）的调查对象从未参加过宫颈癌筛查,不同年龄(t=2.332,P=0.020）、户籍（x²=41.120,P<0.001）、文化程度（x²=11.169,P=0.004）、居住状况（x²=27.529,P<0.001）及职业（x²=7.905,P=0.019）的女性筛查率有差异。曾参与筛查者对宫颈癌筛查的益处认知得分高于从未筛查者（t=2.358,P=0.019）,障碍认知得分低于从未筛查者(t=-7.443,P<0.001）,有行为线索的比例也高于从未筛查者（x²=80.181,P<0.001）。障碍认知（OR=1.884,95%CI:1.311~2.709）与行为线索（OR=2.606,95%CI:1.245~5.453）是宫颈癌筛查行为的影响因素。结论 障碍认知与行为线索对社区女性的宫颈癌筛查行为有影响,帮助改善障碍认知与行为线索是促进个体参与筛查的有效措施,并对不同特征人群开展针对性的宣教。     

Factors associated with colorectal cancer screening among Chinese-Americans

OBJECTIVE: To investigate factors associated with receipt of colorectal cancer (CRC) screening among urban senior Chinese-Americans. METHODS: Two hundred three men and women from three senior centers completed a questionnaire that included sections on demographics, fecal occult blood testing (FOBT) and sigmoidoscopy use, and potential barriers to screening. RESULTS: Receipt of a FOBT within the prior 12 months (37.9% of sample) was associated with fewer years of US residency, lower level of worries or fears of test results, and higher level of perceived susceptibility to CRC. Receipt of a flexible sigmoidoscopy within the past 5 years (22.2% of sample) was associated with higher levels of education, lower levels of worries or fears of test results, and higher level of perceived susceptibility of CRC. CONCLUSIONS: Intervention programs may target these areas to facilitate CRC screening in Chinese-Americans so that national goals can be met for all Americans.     

Breast and cervical cancer screening among Mississippi Delta women

The purpose of the study was to determine breast and cervical cancer screening among women living in the Mississippi Delta region. Using data from the Behavioral Risk Factor Surveillance System for 1999--2000, we determined the prevalence of mammography (women 40 years and older, n = 6,028) and Pap testing (women 18 years and older, n = 6,502) within the past 2 or 3 years, respectively. We examined predictors of testing and compared results with those for women living elsewhere in the United States. Among Delta women, 69.4% (95% confidence interval [CI] 67.9% to 70.9%) had a mammogram and 85.5% (95% CI 84.3% to 86.6%) a Pap test. Mammography prevalence was lower among black and white Delta women than among black and white women elsewhere. Pap testingwas lower among older (65 years and older) Delta women or women who did not visit a doctor within the past year than among their counterparts elsewhere. Additional interventions are needed to meet the goals of Healthy People 2010 for all women.     

Correlates of cervical cancer screening among women in Taiwan

In this study we examine several theory-based psychosocial factors on cervical cancer screening among Chinese women in Taiwan (N = 125). The reliabilities of the scales showed good internal consistence (Chronbach alpha ranged from 0.68 to 0.88). We found that 30% of the women had never received a Papanicolaou (Pap) test, and only 58% reported a screening in the past 3 years (adherent). Intention to have a Pap test in the coming year was higher among screening adherence women (90%) than nonadherents (58%). Multiple logistic regression analysis revealed significant associations between screening adherence and women's knowledge (p = 0.034), perceived pros (p = 0.041), cons (p = 0.000), and norms (p = 0.019) of a Pap test. In addition to identifying screening associated factors, we also provided a basis for measuring important theory-based constructs. Although we developed some scale items for Chinese culture, data showed that psychosocial factors were universally relevant. Future intervention efforts tailoring these factors could potentially impact cancer screening for women internationally.     

深圳市社区人群子宫颈癌CIN现患率及子宫颈癌认知水平调查分析

目的了解深圳地区妇女子宫颈癌现患率与该人群对子宫颈癌及其筛查的认知情况和接受筛查的意愿现状,为我国城市地区进一步开展子宫颈癌的筛查及早诊早治工作提供参考依据。方法以整群抽样的方法选取深圳市龙岗区紫薇社区及福田区梅林社区30~59岁妇女,进行子宫颈癌筛查及对子宫颈癌认知和筛查意愿的调查。初筛方案采用液基细胞学、HPV DNA检测和传统巴氏涂片。所有病变的诊断及转归的判定均以组织病理学检查为依据。采用统一设计的调查表,由经过严格培训的调查员对研究对象进行面对面的问卷调查。筛查结果及流行病学问卷调查结果均采用Visual FoxPro进行数据录入和管理。采用SPSS13.0对数据进行统计分析。结果 1462名妇女完成了调查问卷及子宫颈癌的筛查。调查对象文化程度为初中及高中者约占65.94%;以城镇职工医疗保险为主要医疗保障形式,参保率为67.3%。检出子宫颈癌1例,检出率为0.07%;宫颈上皮内瘤样病变I级(CINI)及以上59例(4.04%),宫颈上皮内瘤样病变II级(CINII)及以上31例(2.12%)。各年龄组CINII及以上的检出率45~49岁年龄组为最高,其次为30~34岁和40~44岁年龄组,但差异均无统计学意义。深圳妇女对子宫颈癌知晓水平为74%,对筛查目的的知晓率为92%,且随着文化程度的增加,认知率也随之增加。参加筛查的原因以自愿参加和职能部门组织为主。研究对象对筛查必要性的认识及筛查费用的支付意愿都很高,达到80%以上,但支付能力较低,62%的妇女只愿意支付200元以下的筛查费用,且不愿意支付费用的原因以费用高和经济困难为主。结论①该人群宫颈上皮内瘤样病变II级(CINII)及以上现患率为2.12%,各年龄组宫颈病变检出差异无统计学意义。②受教育程度是影响子宫颈癌及其筛查目的认识水平的主要因素。③妇女对子宫颈癌筛查必要性的认识及筛查费用的支付意愿都很高,但支付能力较低,目前愿意支付的费用不能满足筛查需求。     

Psychosocial correlates of cervical cancer screening among older Hispanic women

Early detection through screening can reduce mortality rates of cervical cancer, and yet Hispanic women who have incidence rates higher than their non-Hispanic White counterparts are least likely to participate in cancer screening initiatives. This study utilized data from the 2008 wave of the Health and Retirement Study to investigate the psychosocial correlates associated with older Hispanic women’s participation in cervical cancer screening services. Logistic regression models were used. Findings indicated that greater life satisfaction and religiosity were associated with a greater likelihood of participating in cervical cancer screening. Despite ongoing national conversations, evidence indicates there is agreement that underserved women need to be screened, particularly the older Hispanic population.     

Factors associated with obtaining health screening among women of reproductive age.

Death and disability associated with breast and cervical cancer and hypertension can be reduced by early detection and treatment. The authors examined the rates for having obtained a Papanicolaou (Pap) test or pelvic examination, a breast physical examination, and a blood pressure test within the last 12 months among women of reproductive age in the United States in 1988, as reported by the 8,450 women interviewed for the 1988 National Survey of Family Growth. Overall, the annual rates of screening for women ages 15-44 years for those tests were 67 percent for a Pap test or pelvic examination, 67 percent for a breast examination, and 82 percent for a blood pressure test. Standard recommendations for the frequency of screening and survey data were examined to see whether actual screening practice was consistent with those recommendations. More than 90 percent of women who had a family planning service visit within 12 months received each of the tests, regardless of who provided the service or who paid for the visit. Women who were not sexually active, women with little education or low income, American Indian women, Hispanic women, and women of Asian or Pacific Islander descent had lower rates of screening than others, regardless of their risk status. These findings strongly suggest that the likelihood of having obtained screening among women 15-44 years old is determined primarily by how often a woman uses health care, rather than by her risk of disease.     

Understanding the barriers to cervical cancer screening among older women

Despite the fact that 90% of cervical cancers can be prevented by regular Pap screening, many women are not screened regularly, particularly older women. To understand better the barriers to screening, the authors held five focus groups during April 2000 in Prince Edward Island (PEI), Canada. Of the 32% of women aged 45 to 70 who had not been screened over a 5-year period (1995-2000), 60 randomly selected women participated in this research. The authors analyzed discussions for themes using an inductive approach, with interpretation guided by the population health model. Women who have avoided a Pap test are falling between the cracks created by a complex interaction between personal experiences and the health system's approach to Pap screening.     

Factors associated with non-participation in screening for cervical cancer in Southern Brazil

Early detection of cervical cancer substantially increases the probability of cure. The aim of this study was to determine the prevalence and factors associated with non-participation in cervical cancer screening among women 15 to 49 years of age in Rio Grande, Southern Brazil. A representative survey was carried out using a systematic sample based on a census tract. Trained interviewers used standard, individualized, household questionnaires to interview the women. Data analysis used logistic regression according to a previously determined hierarchical framework. Among 1,302 women interviewed, 57% had never had a Pap smear. The risk factors most closely associated with non-participation in screening were black or brown skin color, young age, low family income, low schooling, living alone, and first childbirth after 25 years of age. Coverage for early detection of cervical cancer was very low. In addition, women at high risk of developing cervical cancer were shown to have a significantly higher risk of non-participation in this type of screening.     

Factors associated with female provider preference among African American women, and implications for breast cancer screening

Globally, breast cancer incidence is increasing. Early detection remains important for addressing disparities, including among U.S. minorities. Seeing a female physician increases screening, but the effects of unmet provider gender preference among underserved populations remain unexplored. Among 576 urban African American women age 45-93, we examined predictors of gender preference and how met and unmet preference influenced screening. We conclude that provider gender is a "double-edged sword." We saw a female provider screening benefit, but also that gender preference was associated with past disadvantage and attitudes inconsistent with health maintenance. Provider gender preference merits further consideration in women's health research.     

Time costs associated with cervical cancer screening

OBJECTIVES: Time costs borne by women when undergoing cervical cancer screening have rarely been elucidated, although such costs may pose substantial barriers to care. The purpose of this project was to quantify the opportunity costs associated with cervical cancer screening in young women attending Planned Parenthood Clinics. METHODS: We conducted a self-report survey of 105 women from six clinics to measure travel, waiting, and exam times associated with cervical cancer screening. Respondents recorded their time of arrival and departure, length of time in the waiting room, age, income level, and hours per week they worked outside of the home. Time costs were valued three ways: through self-reported hourly wage, age- and gender-adjusted minimum earnings, and national age- and gender-adjusted hourly wages. RESULTS: Respondents were on average 24 years old, worked 29 hours per week outside the home, and earned less than $20,000 per year. Mean time for one-way travel was 18.7 minutes; waiting room time was 16.9 minutes; and exam time was 50.8 minutes. Time costs were estimated to be $14.08 per visit based upon the self-reported hourly wage; $16.46 per visit based upon age- and gender-adjusted minimum earnings; and $19.63 per visit based upon age- and gender-adjusted national wage rates. CONCLUSIONS: Time costs associated with cervical cancer screening represent an important opportunity cost and should be considered in studies attempting to identify barriers to screening adherence. Our results indicate that time costs accounted for up to 25% of cervical cancer screening costs. Time costs should be identified, measured, valued, and included in cost-effectiveness analyses of cervical cancer screening.     

妊娠期妇女对宫颈癌筛查认知行为的调查研究

目的调查妊娠期妇女对宫颈癌筛查的认知和行为情况,并提出相应的干预措施。方法对2015年7~8月在四川省妇幼保健院产科门诊初次就诊的700例孕妇进行问卷调查,对其宫颈癌筛查知识的认知和行为情况进行分析。结果就诊孕妇对宫颈癌相关知识的知晓率为59%,宫颈检查率为60.71%,宫颈筛查率为56.14%。影响宫颈癌筛查和认知水平的因素为年龄、职业、文化程度、丈夫文化程度、户籍地、收入及常住地。文化程度和收入越高,宫颈癌筛查和认知水平越好。结论应加强对35岁以上、高中及以下文化、非国家机关和企事业单位、非城市户籍的孕妇宫颈癌筛查知识的健康教育,提高知晓率,促进孕妇接受宫颈检查及宫颈癌筛查的行为转变。