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Predictors of Never Being Screened for Cervical Cancer by Metropolitan Area

机译：都市圈从未筛查宫颈癌的预测因素

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Previous studies have shown an association between cervical cancer screening and racial/ethnic minority status, no usual source of care, and lower socioeconomic status. This study describes the demographics and health beliefs of women who report never being screened for cervical cancer by area of residence. Data from the 2010 Behavioral Risk Factor Surveillance System were used to study women aged 21–65 years who reported never being screened for cervical cancer. Multivariate logistic regression modeling was used to calculate predicted marginals to examine associations between never being screened and demographic characteristics and health belief model (HBM) constructs by metropolitan statistical area (MSA). After adjusting for all demographics and HBM constructs, prevalence of never being screened was higher for the following women: non-Hispanic Asians/Native Hawaiians/Pacific Islanders (16.5 %, 95 % CI = 13.7 %, 19.8 %) who live in MSAs; those with only a high school diploma who live in MSAs (5.5 %, 95 % CI = 4.7 %, 6.5 %); those living in non-MSAs who reported “fair or poor” general health (4.1 %, 95 % CI = 3.1 %, 5.4 %); and those living in either MSAs and non-MSAs unable to see a doctor within the past 12 months because of cost (MSA: 4.4 %, 95 % CI = 4.0 %, 4.8 %; non-MSA: 3.4 %, 95 % CI = 2.9 %, 3.9 %). The Affordable Care Act will expand access to insurance coverage for cervical cancer screening, without cost sharing for millions of women, essentially eliminating insurance costs as a barrier. Future interventions for women who have never been screened should focus on promoting the importance of screening and reaching non-Hispanic Asians/Native Hawaiians/Pacific Islanders who live in MSAs.
机译：先前的研究表明子宫颈癌筛查与种族/少数族裔地位，没有常规的护理来源以及较低的社会经济地位之间存在关联。这项研究描述了据报告从未按居住地区进行宫颈癌筛查的妇女的人口统计学和健康信念。 2010年行为危险因素监测系统的数据用于研究21-65岁的女性，她们从未接受过宫颈癌筛查。多变量逻辑回归模型用于计算预测的边际，以通过都市统计区域（MSA）检验从未筛选的人口统计学特征与健康信念模型（HBM）构造之间的关联。在调整了所有人口统计学和HBM结构后，以下女性的从未筛查患病率更高：生活在MSA中的非西班牙裔亚洲人/夏威夷原住民/太平洋岛民（16.5％，95％CI = 13.7％，19.8％）；仅拥有高中文凭的人生活在MSA中（5.5％，95％CI = 4.7％，6.5％）；生活在非MSA中且总体健康状况“中等或较差”的人群（4.1％，95％CI = 3.1％，5.4％）；而那些生活在MSA和非MSA中的人在过去12个月内由于费用而无法看医生（MSA：4.4％，95％CI = 4.0％，4.8％；非MSA：3.4％，95％CI = 2.9％，3.9％）。 《平价医疗法案》将扩大宫颈癌筛查的保险覆盖范围，而无需数百万妇女分担费用，从根本上消除了保险费用的障碍。对于从未接受过筛查的妇女，未来的干预措施应集中在提高筛查的重要性上，并惠及生活在MSA中的非西班牙裔亚洲人/夏威夷本地人/太平洋岛民。

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