PO.PS01.09 · 人群科学
在社区健康中心网络中美国拉丁裔女性的宫颈癌筛查与预防
Cervical cancer screening and prevention among Latinas in the U.S. among a network of community health centers
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摘要 Abstract
中文摘要
引言：及时的宫颈癌筛查对于中老年拉丁裔女性至关重要，她们因宫颈癌而承受高发病率和死亡率，但我们目前对该人群的筛查了解较少。吸引中老年拉丁裔移民参与的努力需要量身定制，以认识到她们来到美国的独特经历，这些经历可能使她们区别于其他群体。拉丁裔女性往往不成比例地在社区健康中心（CHC）接受照护，而CHC是癌症筛查和预防的重要组成部分。本研究利用一个全国性CHC网络，评估中老年拉丁裔女性在宫颈癌筛查方面的差异及利用情况。
方法：对来自美国多州CHC网络的电子健康记录数据进行回顾性分析。数据提取自2014年1月1日至2022年9月14日期间、在15个州527家社区初级保健诊所中、出生国已知且至少有一次在CHC进行面对面初级保健就诊的、年龄>45岁的拉丁裔和非西班牙裔白人（NHW）女性。为检验研究期间是否曾接受过至少一次巴氏涂片检查和/或人乳头瘤病毒（HPV）检测，进行了广义估计方程（GEE）logistic回归，包括总体分析及按出生国分层分析。
结果：在34,135名患者中，我们发现，除美国出生的拉丁裔女性及来自样本量过小而无法单独分析的其他国家者外，所有拉丁裔群体与非西班牙裔白人相比接受HPV或巴氏检测的几率更高。按出生国分层时，所有出生于中美洲的拉丁裔群体的几率均高于非西班牙裔白人。所有三个模型均显示，与非西班牙裔白人患者相比，拉丁裔女性在研究期间至少接受一次HPV或巴氏检测的几率更高。
结论：CHC在应对拉丁裔等多样化和服务不足人群方面可能具有独特优势；然而，筛查率仍不理想，仍需继续努力。
查看英文原文 English abstract
Introduction: Timely cervical cancer screenings are critical for middle to older aged Latinas, who have high morbidity and mortality from cervical cancer, but we currently know less about screening in this population. Efforts to engage middle to older-age Latina immigrants need to be tailored to recognize their distinct experiences with coming to the US that may set them apart from other groups. Latinas tend to receive disproportionate care in Community Health Centers (CHCs) and CHCs are a vital component for cancer screening and prevention. This study leverages a national network of CHCs to assess disparities in and utilization of cervical cancer screening among middle to older age Latinas.
Methods: Retrospective analysis of electronic health record data from a multistate network of CHCs across the United States. Data were extracted on Latina and non-Hispanic White (NHW) women age >45 with known birth country and at least one in-person primary care visit in a CHC between January 1, 2014, and September 14, 2022, across 527 community-based primary care clinics in 15 states. To examine the receipt of at least one Pap Smear and/or Human papilloma Varus (HPV) test ever during the study period, generalized estimating equations (GEE) logistic regression were conducted, overall and disaggregated by country of origin.
Results: Among 34,135 patients, we found that all Latina groups aside from US born Latinas and those from other countries with sample sizes too small to analyze individually had higher odds of receiving either an HPV or Pap test compared to non-Hispanic Whites. When disaggregated by country of origin, all Latina groups born in Central America have higher odds than non-Hispanic Whites. All three of the models showed that Latinas had higher odds of receiving either an HPV or Pap test at least once during the study period compared to non-Hispanic White patients.
Conclusion: CHCs may have unique strengths to address diverse and underserved populations such as Latinas; however, rates remain less than optimal, and work is still needed
利益披露 Disclosure
S. Rushton, None..
T. Hodes, None..
J. A. Lucas, None..
C. Vasquez Guzman, None.