研究揭示了为什么宫颈癌筛查率下降，哪些人群受到影响最大
Rates of cervical cancer screening have dropped in the U.S., with screening rates lowest among Asian and Hispanic women, as well as women who live in rural areas, don’t have insurance, or identify as LGBQ+, according to researchers with The University of Texas Health Science Center at Houston (UthealthHouston）。
A nationally representative cross-sectional study of 20,557 women led by瑞安·苏克（Ryan Suk），博士Uthealth公共卫生学院的管理，政策和社区卫生助理教授揭示了所有社会人口统计学组中没有最新宫颈癌筛查的妇女比例的重大增加，从2005年的14.4％到23.0％，达到23.0％2019年学习，，，，which pulled data from the National Health Information Survey (NHIS) from the Centers for Disease Control and Prevention (CDC), was published today inJAMA网络开放。
在不同的社会人口统计学群体之间发现了主要差异。尽管如此，最常报道的没有在所有群体中进行及时筛查的原因是缺乏知识，范围为47.2％的女性，识别为LGBQ++ 64.4％的西班牙裔妇女。
“What this means is that more campaigns about cervical cancer screenings are needed,” Suk said. “There would need to be targeted, culturally adapted campaigns for each of these sociodemographic groups.”
我们明显较高的逾期筛查re found among women of Asian descent compared with those of non-Hispanic white race and ethnicity (31.4% vs. 20.1%). There were also higher rates among women living in rural versus urban areas (26.2% vs. 22.6%); those without insurance versus those with private insurance (41.7% vs. 18.1%); and women identifying as LGBQ+ versus heterosexual (32.0% vs. 22.2%). Transgender individuals could not be identified because the NHIS data does not have information on transgender and only includes a binary sex variable of male and female.
Other key findings include:
- 与非西班牙裔白人妇女相比，亚洲和西班牙裔妇女都更有可能进行筛查，但其原因在种族和种族中都有不同。尽管亚洲和西班牙裔妇女都报告缺乏障碍知识，但亚洲妇女更有可能报告医疗保健专业人员的建议缺乏建议，并且认为没有障碍的感觉，而西班牙裔妇女的可能性是亚洲妇女的两倍，而亚洲妇女的可能性是不足的两倍。作为障碍的访问权限。
- 各个年龄段的筛查率也存在差异。2019年，21至29岁的妇女与30至65岁的妇女（21.1％）相比，逾期筛查率（29.1％）明显更高。自2007年以来，先前收到的HPV疫苗已被推荐给26岁以来的女性，这并不是任何年龄段不进行最新筛查的主要原因。但是，在年龄较大的妇女中，那些回应她们没有接受筛查的人，因为她们没有在2019年的医疗保健从业人员中提出的建议，从5.5％增加到12.0％。
- The proportion of women reporting lack of access as their primary barrier to receiving a timely screening decreased significantly from 2005 to 2019 across all age groups, possibly representing benefits from Medicaid expansion and the Affordable Care Act’s emphasis on access to the U.S. Preventive Services Task Force-recommended preventive cares.
苏克说，这些发现强调了卫生保健专业人员在促进宫颈癌筛查方面提出建议的重要性，随着获得护理的机会的不断提高，这可能会发挥更大的作用。
Suk说：“及时的宫颈癌筛查是对宫颈癌的关键预防措施，尤其是对于那些无法从HPV疫苗引入的人来说。”“大多数宫颈癌病例都是可以预防的，我们需要花费更多的精力来提高整体及时筛查率，也需要减少各种人群的差异。这项研究强调并提醒我们，我们需要采取更具包容性和可持续性的方法来实施这种基于证据的筛查策略。”
该报告的Uthealth Houston的合着者包括Uthealth Public Health的管理，政策和社区健康部副教授Suja S. Rajan博士，以及该学校的研究助理MS Yenan Zhu。beplay苹果手机能用吗其他合着者包括佛罗里达大学的Young-Rock Hong博士和MPA的Zhigang Xie，以及德克萨斯大学奥斯汀大学的Jennifer C. Spencer博士。
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