海南省农村妇女宫颈癌认知和筛查行为及影响因素分析

目的了解海南省35~64岁农村妇女宫颈癌防治知识认知和检查行为状况及相关影响因素,为开展宫颈癌健康教育及筛查提供参考依据。方法采取多阶段分层抽样方法对海南省18个市县的10800名农村妇女进行宫颈癌防治知识问卷调查,采用描述性分析、多因素Logistic回归等方法进行统计分析。结果调查对象普遍对宫颈癌的危险因素和预防措施了解不足,49.3%的调查对象主动做过临床宫颈癌检查,53.4%的妇女参加过国家宫颈癌筛查服务。Logistic回归分析结果显示,文化程度越高(OR=0.818)、收入越高(OR=0.694)、未患慢性病(OR=2.053)、参加过宫颈癌筛查项目(OR=2.054)、职业为个体户(OR=0.714)和教师(OR=0.872)的调查对象防治知识得分较高;年龄越大(OR=0.817)、少数民族(OR=0.577)、已婚(OR=0.452)、文化程度越高(OR=0.913)、职业为教师(OR=0.602)、收入越高(OR=0.744)、具备宫颈癌防治知识(OR=0.1.951)的调查对象越会主动进行宫颈癌检查。结论海南省农村妇女宫颈癌防治知识掌握程度不高,应进一步采取有效方式开展广泛深入的健康教育,提高宫颈癌防治知识水平,促使农村妇女主动进行宫颈癌检查。     

海南省农村妇女宫颈癌认知和筛查行为及影响因素分析

目的了解海南省35~64岁农村妇女宫颈癌防治知识认知和检查行为状况及相关影响因素,为开展宫颈癌健康教育及筛查提供参考依据。方法采取多阶段分层抽样方法对海南省18个市县的10800名农村妇女进行宫颈癌防治知识问卷调查,采用描述性分析、多因素Logistic回归等方法进行统计分析。结果调查对象普遍对宫颈癌的危险因素和预防措施了解不足,49.3%的调查对象主动做过临床宫颈癌检查,53.4%的妇女参加过国家宫颈癌筛查服务。Logistic回归分析结果显示,文化程度越高(OR=0.818)、收入越高(OR=0.694)、未患慢性病(OR=2.053)、参加过宫颈癌筛查项目(OR=2.054)、职业为个体户(OR=0.714)和教师(OR=0.872)的调查对象防治知识得分较高;年龄越大(OR=0.817)、少数民族(OR=0.577)、已婚(OR=0.452)、文化程度越高(OR=0.913)、职业为教师(OR=0.602)、收入越高(OR=0.744)、具备宫颈癌防治知识(OR=0.1.951)的调查对象越会主动进行宫颈癌检查。结论海南省农村妇女宫颈癌防治知识掌握程度不高,应进一步采取有效方式开展广泛深入的健康教育,提高宫颈癌防治知识水平,促使农村妇女主动进行宫颈癌检查。     

Previous Cancer Screening Behavior as Predictor of Endoscopic Colon Cancer Screening Among Women Aged 50 and Over, in NYC 2002

Colon cancer screening rates in women are low. Whether screening for breast and cervical cancer is associated with colon cancer screening behavior is unknown but could provide linkage opportunities. To identify the extent to which both breast and cervical cancer screening increases uptake of colon cancer screening among women in New York City. Women at least 50 years old completed questionnaires for the New York Cancer Project. Analyses compared rates of endoscopic colon cancer screening with adherence to screening recommendations for breast and cervical cancer. Of the 3,386 women, 87.8% adhered to breast and cervical cancer screening guidelines, yet only 42.1% had received endoscopic colon cancer screening. Most women with colon cancer screening (95%) also reported past mammogram and Pap-smear. In multivariable analysis, women who adhered to the other two procedures were more likely to have had colon cancer screening than women with no prior history (OR = 4.4; CI = 2.36, 8.20), after accounting for age, race/ethnicity, insurance status, family history of cancer and income. Significant predictors of endoscopic colon cancer screening included: age over 65 years (OR = 1.63; CI = 1.23, 2.15) with 50–65 years old as the reference, any health insurance (OR = 2.18; CI = 1.52, 3.13) and a family history of cancer (OR = 1.38; CI = 1.17, 1.61). Colorectal cancer screening remains low, even among women who undergo other cancer screening tests. Opportunities to link cancer screening tests to encourage colon cancer screening merit closer attention.     

Cervical Cancer Risk as a Predictor of Pap Smear Use in Rural North Carolina

Risk for invasive cervical cancer is reported to be higher in rural areas than urban ones, and cervical cancer-related mortality is higher in rural women due to poorer utilization of preventive services and subsequent presentation at late stages of the disease. This cross-sectional study examined the relationship between prevalence of risk factors for cervical cancer and the degree of compliance with risk-appropriate screening guidelines for cervical cancer. Secondary data were analyzed for 614 women from Robeson County, NC, aged 40 and older, and of mainly rural and low socioeconomic status. High-risk status was determined by the presence of any of the following five risk factors: a history of more than two sexual partners, age at first sexual intercourse under 18 years, history of sexually transmitted disease, history of sexually transmitted disease in sexual partner(s), and smoking. Low-risk status was the absence of all factors. A high-risk participant was considered compliant if she had had at least three Pap smears in the 3 years prior to the interview, while a low-risk participant was considered compliant if she had had at least one Pap smear within the previous 3 years. Overall, 82% of the participants were at high risk for cervical cancer. However, only 41% of all participants were compliant with the risk-appropriate screening guidelines. Low-risk status was significantly associated with compliance with cervical cancer screening guidelines (adjusted OR = 6.7; 95% CI = 3.7 to 11.1, p = .0001). Findings in this study population suggest rural women at high risk for cervical cancer are less likely to be compliant with appropriate Pap smear screening guidelines, indicating the need to target educational programs.     

Predictors of prostate cancer screening among health fair participants

OBJECTIVES: Most previous studies of predictors for participation in prostate-specific antigen (PSA) screening for prostate cancer have been conducted in purposive samples or clinical settings. This population-based study identified factors associated with documented PSA screening among health fair participants. STUDY DESIGN: Cross-sectional survey of 2098 Nebraskan men aged 35 years and older who participated in a health fair in central and eastern Nebraska in 1993. METHODS: All participants were offered a PSA screening and a questionnaire to collect information on demographics, family medical history, lifestyle factors and self-perceived health status. Predictors of PSA screening were estimated by odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Men were more likely to accept the PSA screening if they were older than 50 years of age (OR=3.1; 2.4-3.9), had a higher income (OR=1.5; 1.1-2.1), were currently employed (OR=1.4; 1.0-2.5), perceived their health status as good (OR=1.1; 0.8-1.5) or excellent (OR=1.4; 1.0-2.1), and believed that they themselves, rather than physicians, should be responsible for their health (OR=1.3; 1.0-1.7). Compared with men aged 50-59 years, the ORs of participation were 0.8 (0.6-1.1) for age 60-69 years and 0.7 (0.5-1.1) for age 70+ years. Decision making was not related to education, marital status or body mass index. Predictors of screening remained unchanged when analysis was limited to men aged 50 years and over, whereas only high income and non-smoking status predicted participation among men younger than 50 years of age. CONCLUSIONS: Age, income, employment status, perceived control of health and perceived heath status were related to participation in PSA screening for prostate cancer, particularly in men older than 50 years of age. Willingness to receive a PSA screening among men aged 50 years and over decreased with increasing age.     

Characteristics of women using organized or opportunistic breast cancer screening in France. Analysis of the 2006 French Health,Health Care and Insurance Survey

BackgroundThis study aimed at (i) estimating the 2-year self-reported breast cancer screening coverage rate; and (ii) analyzing the relationships between sociodemographic characteristics and healthcare access of women and breast cancer screening (opportunistic or organized) practices.MethodsFrom a 2006 French health survey, 2056 women aged 50 to 74 years were selected and divided into three groups according to their breast cancer screening practices during the previous 2 years: organized screening, opportunistic screening, or no screening. The three groups were compared according to self-reported sociodemographic status, healthcare access, screening behaviors, and perceived health, using polytomic regression.ResultsThe 2-year self-reported coverage rate was 75.8%. It was high among women aged 50 to 69 years and lower among older women. Questions relating to medical access (i.e. having consulted a GP in the last 12 months, having consulted a gynecologist in the last 12 months, and having had a Pap smear in the last 3 years) were the variables most commonly associated with a recent mammogram. Women having a regular follow-up by a gynecologist or having had cervical cancer screening within the last three years used organized breast cancer screening more often and used opportunistic breast cancer screening even more often than other women.ConclusionThe study confirmed the key role of gynecologists and general practitioners in encouraging women to have a mammogram. Awareness among healthcare professionals and women of the benefits of organized breast cancer screening compared to opportunistic screening should be sustained and strengthened.     

上海市虹口区离退休及低保妇女参与宫颈癌筛查相关因素研究

目的:了解影响社区妇女参与宫颈癌筛查的主要相关因素,为有效的干预提供基础。方法:采用自我效能量表和自行设计的知识态度及影响因素调查问卷,对上海市虹口区502例离退休及低保妇女进行问卷调查。问卷内容根据社会认知理论模型设计。结果:83.9%的调查对象曾经参与宫颈癌筛查,其中46.5%(所有调查对象中的39.0%)在3年内参加过宫颈癌筛查,多因素分析显示影响妇女曾经参与宫颈癌筛查的因素有:单位组织筛查、婚姻状况、医生推荐、周围人影响,且均为正向影响因素;而影响妇女3年内参与宫颈癌筛查的因素有:文化程度、社区组织筛查、离退休年数、医生推荐、宫颈癌及筛查相关知识、自我效能,这些影响除离退休年数为负向,其他均为正向相关因素。结论:上海市虹口区妇女3年内参与宫颈癌筛查率较低,应采取健康教育、提高妇女自我效能、提高医生对宫颈癌筛查的认识、提供免费筛查服务等多方面措施。在健康教育时应特别关注绝经后妇女,鼓励妇女家人同时参加。     

Clinical and demographic predictors of late-stage cervical cancer

BACKGROUND: Despite increasingly widespread use of the Papanicolaou smear, almost half of all women with invasive cervical cancer are diagnosed at a late stage (regional or distant). Little is known about factors associated with late-stage diagnosis of cervical cancer. OBJECTIVE: To examine the relationship of age, race, education level, income level, smoking, marital status, health insurance type, comorbidity, and residence in an urban or rural setting to late stage at diagnosis of cervical cancer. METHODS: Incident cases of invasive cervical cancer occurring in 1994 in Florida were identified from the state tumor registry (N = 852). Cases were linked with state discharge abstracts and the 1990 US census. Multiple logistic regression was used to determine the relationship between predictor variables (age, race or ethnicity, marital status, smoking status, education level, income level, insurance type, comorbidity, and urban vs rural residence) and the odds of late-stage diagnosis. RESULTS: Age, marital status, and insurance type were associated with late-stage diagnosis. Each additional year of age was associated with a 3% increased odds of late-stage diagnosis (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05; P<.001). Being unmarried was associated with a 63% increased odds of late-stage diagnosis (OR, 1.63; 95% CI, 1.18-2.25; P=.003). Being uninsured was associated with a 60% increased odds of late-stage diagnosis (OR, 1.60; 95% CI, 1.07-2.38; P=.02). Having commercial health maintenance organization insurance was associated with a 46% decreased odds of late-stage disease (OR, 0.54; 95% CI, 0.30-0.96; P=.04). Race, education level, income level, smoking status, comorbidity, and urban residence were not associated with stage at diagnosis. CONCLUSIONS: Women with cervical cancer who are elderly, unmarried, and uninsured are more likely to be diagnosed at a late stage. These women should be targeted for cervical cancer education and screening programs.     

贵阳市2015-2019年农村妇女宫颈癌和乳腺癌筛查情况分析

目的 了解贵阳市2015-2019年农村妇女宫颈癌和乳腺癌（简称“两癌”）筛查状况,为“两癌”的筛查模式和防治对策提供科学依据。 方法 提取妇幼重大公共卫生项目信息直报系统数据,对贵阳市2015-2019年“两癌”筛查数据进行分析。 结果 2015-2019年贵阳市接受宫颈癌筛查的妇女共计240 074例,分别检出CIN1、CIN2和CIN3、宫颈癌为343例、398例和55例,检出率分别为142.87/10万、165.78/10万和22.91/10万。各年份仅CIN1的检出率差异有统计学意义（x2=25.664, P ＜0.001）;接受乳腺癌筛查的妇女共15 791例,检出乳腺癌9例,检出率为56.99/10万,各年份检出率无统计学差异（x2=2.897, P =0.575）。 结论 贵阳市宫颈癌和乳腺癌检出率水平总体较高,一方面应继续鼓励更多的农村妇女参与“两癌”筛查,知晓筛查的重要性;另一方面要加强对农村妇女的健康宣教,提高对“两癌”防治知识的知晓率,做到“三早”预防以降低“两癌”的发病率和死亡率,保护妇女健康。     

基于健康信念模型的济南市妇女宫颈癌筛查行为影响因素研究

目的 以健康信念模型（health belief model,HBM）为理论基础,探索济南市妇女宫颈癌筛查行为的影响因素。 方法 基于济南市“两癌筛查”项目,对济南市9个区进行方便抽样,使用基于HBM理论的宫颈癌筛查问卷进行调查,对曾做过宫颈癌筛查和从未做过此筛查的人群进行对比,分析济南市妇女宫颈癌筛查行为的影响因素。 结果 共收回有效问卷1441份,有效率为79.0 %,其中942（65.5%）份为曾筛查组问卷,499（34.5 %）份为未筛查组问卷。曾筛查组在筛查自我效能、筛查益处、筛查障碍等维度的平均得分均高于未筛查组但在宫颈癌易感性和严重性的平均得分低于未筛查组（P＜0.05）。Logistic回归分析显示居住地（OR=1.327, 95%CI:1.007~1.749）、文化程度（OR=1.414, 95%CI:1.079~1.853）、筛查益处认知（OR=2.061, 95%CI:1.56 ~2.72）和筛查障碍认知（OR=1.466, 95%CI:1.22~1.763）是济南市妇女宫颈筛查的独立影响因素。结论 济南市女性宫颈癌筛查信念较好。优化农村贫困人群筛查策略、加强宫颈癌筛查科普、减少筛查障碍是提高济南妇女筛查率的可行措施。     

宫颈癌筛查对农村妇女相关防治知识影响因素分析

目的了解北京市宫颈癌免费筛查前后对大兴区农村地区30～59岁妇女的宫颈癌防治知识知晓率的变化,探索其影响因素,以便制订相应防治策略。方法采用三阶段分层随机及按固定样本量分配样本数量选取研究对象,分别在北京市宫颈癌免费筛查启动的前一年（2008年）和启动年（2009年）对妇女宫颈癌防治知识进行横断面一对一方式的调查。结果单因素分析显示：在北京市宫颈癌免费筛查项目启动后,大兴区妇女宫颈癌总体知晓率显著提高,被调查的农村妇女宫颈癌相关知识总体知晓率有显著提高,答对5题以上的妇女比例从启动前的37．3％提高到51．0％（χ^2=62．06,P〈0．001）;在调整其他混杂因素后,多因素分析结果亦显示宫颈癌筛查有利于宫颈癌相关知识知晓率的提高（OR=1．853,95％CI：1．590～2．159）。此外,单因素分析显示,居住地、文化程度、家庭年人均收入、有否5年内筛查史是影响妇女知晓率的主要因素,且文化程度、家庭年人均收入等级越高,知晓率越高（DR值分别为1．766和2．580及OR值分别为1．350和1．676）。结论通过北京市免费筛查宫颈癌和健康教育宣传活动确实能够提高广大妇女宫颈癌防治知识水平,尤其是对于以往没有参加过筛查的群体,可以提高她们的参与意识。     

深圳市社区子宫颈癌筛查结果分析

目的:探讨HPH感染与宫颈癌前病变及宫颈癌的关系,并提出相应的干预措施。方法:2006年4月～2008年4月选取开展妇女健康体格检查较好的深圳市福田区教育系统及尚未很好开展子宫颈癌筛查的深圳市龙岗区居民社区健康妇女为研究对象,对30～60岁妇女进行人类乳头瘤病毒(HPV)检测及阴道镜检查筛查子宫颈癌前病变(子宫颈上皮内瘤变,CIN)和子宫颈癌。结果:筛查深圳市福田区教育系统女性教职工1761例,HPV阳性者208例(11.81%),≥CINⅠ病变34例(1.93%);深圳市龙岗区紫薇社区妇女764例,HPV阳性者122例(16.00%),≥CINⅠ病变34例(4.57%),两者差异有统计学意义(χ2=8.1049,P=0.0044,χ2=12.9075,P=0.0003);HPV阳性者≥CINⅠ病变检出率明显高于HPV阴性者(OR=25.47,95%CI:14.35～45.23);以病理组织学诊断为金标准,评价HPV检测对预测子宫颈上皮内瘤样病变(≥CINⅠ病变)的临床价值,其敏感度:76.47%,特异度:88.69%,阳性预测值:15.75%,阴性预测值:98.46%。结论:HPV感染与子宫颈癌前病变及子宫颈癌密切相关,应将HPV感染者作为高危人群进行监测;健康人群普查能有效预防子宫颈癌前病变及子宫颈癌;应加强健康教育,促进健康人群自觉参与子宫颈癌筛查。     

Predictors of cervical cancer screening among Kenyan women: results of a nested case-control study in a nationally representative survey

Background

Cervical cancer is a major public health concern in Kenya. It is the leading cause of cancer morbidity and mortality among women. Although screening is an effective prevention method, uptake is low among eligible women. Little is known about predictors of cervical cancer screening uptake. This study explored relationship between uptake of cervical cancer screening, socio-demographic, behavioral and biological risk factors.

Methods

Nested case-control study within STEPS survey, a population-based cross-sectional household survey conducted between April and June 2015.Cases were women who had undergone cervical cancer screening and controls were unscreened women. Study participants were women eligible for cervical cancer screening (30–49 years). Variables included socio-demographic; behavioral risk factors such as physical activity, tobacco and alcohol use diet and biological factors like diabetes and hypertension. Outcome of interest was cervical cancer screening. Data analysis was done using STATA version 14. Logistic regression model was used to assess relationship between cervical cancer screening and socio-demographic, behavioral and biological risk factors.

Results

Of 1180 women interviewed, 16.4% (n?=?194) had been screened for cervical cancer. Of unscreened women (n?=?986), 67.9% were aware of cervical cancer screening. Higher screening rates were observed in more educated women (25.2%), highest income quintile (29.6%) and living in urban areas (23%) than in women with no formal education (3.2%), poorest (3.6%) and living in rural areas (13.8%). Younger women (35–39) and those with low High-density lipoprotein (HDL) were less likely to be screened [OR?=?0.56; 95% CI?=?(0.34, 0.93); p-value?=?0.025] and [OR?=?0.51; 95% CI?=?(0.29, 0.91); p?=?value 0.023] respectively. Self-employed women, those in the fourth wealth quintile, binge drinkers, high sugar consumption and insufficient physical activity were more likely to be screened [OR 2.55 (1.12, 5.81) p value 0.026], [OR 3.56 (1.37, 9.28) p value 0.009], [OR 5.94 (1.52, 23.15) p value 0.010], [OR 2.99 (1.51, 5.89) p value 0.002] and [OR 2.79 (1.37, 5.68) p value 0.005] respectively.

Conclusion

Uptake of cervical cancer screening is low despite high awareness. Strategies to improve cervical cancer screening in Kenya should be implemented with messages targeting persons with both risky and non-risky lifestyles especially younger women with no formal education living in rural areas.

     

Peer Reviewed: Factors Associated With Cervical Cancer Screening in Puerto Rico

Introduction

Racial/ethnic disparities in cervical cancer screening exist in the United States; rates are lowest among women who live in Puerto Rico. We identified factors associated with cervical cancer screening among women aged 18 years or older living in Puerto Rico.

Methods

We included women who participated in the Puerto Rico Behavioral Risk Factor Surveillance System in 2006 who had not had a hysterectomy (n = 2,206). We calculated the weighted population prevalence estimates of Papanicolaou (Pap) test screening in the past 3 years and used logistic regression models to assess factors associated with screening.

Results

Most participants (71.9% [95% confidence interval (CI)Most participants (71.9% [95% confidence interval (CI) = 69.4%-74.4%]) reported having had a Pap test in the preceding 3 years. Factors associated with screening in multivariate analysis included routine checkup in the past year and leisure-time physical activity. Compared with women with a household income less than $15,000, those with higher incomes were more likely to have had a Pap test. Similarly, divorced or separated women were more likely to have been screened (odds ratio [OR] = 1.13; 95% CI = 1.12-1.15) than those who were married/living together. We did not find associations between screening behavior and education, health care coverage, body mass index, or smoking status.

Conclusion

The prevalence of cervical cancer screening in Puerto Rico is below the 90% recommendation established by Healthy People 2010. Our findings regarding factors associated with Pap screening behavior identified population subgroups who are underscreened and who may benefit from targeted interventions and screening programs.     

Limited Pap screening associated with reduced risk of cervical cancer in South Africa

BACKGROUND: We investigated the effect of Pap smear screening on the incidence of invasive cancer of the cervix in the Western Cape, South Africa where screening is limited. METHODS: Data were derived from a case-control study of the association of hormonal contraceptives and invasive cervical cancer. Incident cases (n = 524) of invasive cervical cancer who presented at two tertiary hospitals and controls (n = 1540) series matched for age, race, and place of residence were interviewed. Information on a wide range of variables was collected including whether the women had previously had a Pap smear taken and the number and timing of smears. Odds ratios (OR) and 95% CI were calculated using multiple logistic regression. RESULTS: The OR of cervical cancer was reduced among women who had ever had a smear (OR = 0.3, 95% CI: 0.3-0.4). The OR declined with increasing number of smears to 0.2 for >/=>3 smears (trend P = 0.0003). Among women who had a smear <5 years previously the OR was 0.3, but even if the smear was taken >/=15 years previously the women remained at reduced risk (OR = 0.5). CONCLUSION: The data suggest that even limited Pap smear screening reduces the risk of cervical cancer. Should a screening programme be successfully implemented, the incidence of cervical cancer might be reduced by as much as 70%.     

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.     

Breast and cervix cancer screening among multiethnic women: role of age, health, and source of care

OBJECTIVE: The aim of this study was to evaluate the relationships between age, health status, access to care, and breast and cervical cancer screening among multiethnic elderly and nonelderly women. METHODS: A structured telephone survey of a quota sample of 1,420 New York City women from four Hispanic groups (Columbian, Dominican, Puerto Rican, Ecuadorian) and three black groups (U.S., Caribbean, and Haitian) was performed. Outcome measures included "ever" and "recent" self-reported use of mammography, clinical breast examination (CBE), and Pap smears. Logistic regression models assessed the predictors of screening use. RESULTS: Having a regular source of care significantly predicted all screening use for both elderly and nonelderly, controlling for ethnicity, sociodemographics, health status, access to care, proportion of life in the United States, and cancer attitudes. Elderly women (>/=65 years) were significantly less likely to have ever had (OR = 0.79, 95% CI 0.65-0. 96) and to have recently had (OR = 0.67, 95% CI 0.57-0.79) Pap smears than younger women, controlling for the other variables; being elderly also tended to be an independent predictor of ever and recent mammography and CBE use. Interestingly, there was a trend for health status to act differently in predicting Pap smear use for the two age groups. For younger women, being in poor health increased the odds of Pap smear screening, while for elderly women, being in good health increased the odds of screening. CONCLUSIONS: Elderly women reported being screened less than younger women; interactions between health status and age need further exploration.     

The comparison of health behaviors between widowed women and married women in jeollanamdo province, Korea

OBJECTIVES: To compare the health behaviors of widowed women with those of currently married women. METHODS: We randomly sampled the subjects from the Jeollanamdo Resident Registration Data and we then selected 2,331 widowed women and 4,775 married women. Well-trained examiners measured the height, weight, blood pressure and abdomen circumference, and the women were interviewed with using a questionnaire. Logistic regression analysis was used to estimate the odds ratios(OR) of the two groups. RESULTS: The smoking rate (OR=2.46; 95% confidence interval [CI]1.65, 3.66) was significantly higher for the widowed women. On the contrary, the awareness rate of a smoking cessation campaign (OR=0.80; 95% CI=0.70, 0.92), a quit tobacco telephone line (OR=0.73; 95% CI=0.61, 0.88) and a quit smoking clinic (OR=0.74; 95% CI=0.62, 0.89) were lower for the widowed women. The rate of receiving a health exam (OR=0.80; 95% CI=0.70, 0.91), the rate of undergoing gastric cancer screening (OR=0.77; 95% CI=0.68, 0.88), breast cancer screening (OR=0.79; 95% CI=0.69, 0.89), cervix cancer screening in the last 2 years (OR=0.81; 95% CI=0.71, 0.92), colon cancer screening in the last 5 years (OR=0.74; 95% CI=0.63, 0.87) were significantly lower for the widowed women. CONCLUSIONS: This study revealed that the health behaviors are significantly different between the widowed women and the married women. To improve the health behaviors of the widowed women, further study and research that will investigate the socioeconomic and environmental factors that affect the health behaviors of widowed women will be needed.     

Reasons women do not attend screening for cervical cancer: a population-based study in Sweden

BACKGROUND: With an improved compliance with screening a larger reduction of cervical cancer incidence would be within reach. We aimed at investigating why certain women do not attend Pap smear screening and at validating the reliability of self-reported screening. METHODS: In 1998 in the county of Uppsala, Sweden, information was collected through telephone interviews with 430 nonattendees and 514 attendees to Pap smear screening, who were all sampled from a population-based database. The women's recall of attendance was validated against the database. The main outcome measures used were odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Non-attendance was positively associated with nonuse of oral contraceptives (OR = 3.56, 95% CI 2.18-5.83), seeing different gynecologists (OR = 1.90, 95% CI 1.34-2.70), and seeing a physician very often (OR = 3.12, 95% CI 1.45-6.70) or not at all (OR = 1.78, 95% CI 1.09-2.90). Frequent condom use (OR = 1.88, 95% CI 1.02-3.47), living in rural/semirural areas (OR = 1.55, 95% CI 1.07-2.21), and not knowing the recommended screening interval (OR = 2.16, 95% CI 1.20-3.89) were all associated with nonattendance, whereas socioeconomic status was not, when tested in a multivariate model. Among the nonattendees, 57% underestimated the time lapse since last smear. CONCLUSIONS: Seeing a gynecologist on a regular basis and information guiding women to have a Pap smear on their own initiative are important factors for recurrent screening. Therefore, information should be given to all women about the purpose and benefits of Pap smear testing. Self-reports on screening should be treated with caution.