德国海德堡大学Pascal Geldsetzer团队分析了55个中低收入国家的宫颈癌筛查率。2020年10月20日，《美国医学会杂志》发表了该成果。
世界卫生组织正在制定一项消除宫颈癌的全球战略，其目标是筛查30至49岁女性的患病率。然而，关于中低收入国家（LMICs）宫颈癌筛查水平的证据很少。
为了确定LMICs中终生宫颈癌筛查率及其在世界各地区和国家内的变化，2005-2018年，研究组对55个中低收入国家进行了横断面全国代表性的住户调查分析。各项调查的中位答复率为93.8％。以人群为基础的样本包括1136289名15岁及以上的女性，其中6885名（0.6％）缺少有关宫颈癌筛查的调查信息。
在最终分析的1129404名女性中，有542475名年龄在30至49岁之间。各个国家/地区中30至49岁年龄段女性自我报告曾筛查过的中位数为43.6％，拉丁美洲和加勒比地区的筛查率最高，为84.6%，撒哈拉以南非洲地区的筛查率最低，仅为16.9%。
在区域内国家之间，以及在人均国内生产总值和卫生总开支水平相似的国家之间，自我报告的终生宫颈癌筛查率存在很大差异。在国家内部，生活在农村地区、受教育程度低或家庭财富低的妇女通常没有接受过宫颈癌筛查。
总之，在这项涉及55个中低收入国家的横断面分析中，各国自我报告的宫颈癌终生筛查率之间存在很大差异。
附：英文原文
Title: Lifetime Prevalence of Cervical Cancer Screening in 55 Low- and Middle-Income Countries
Author: Julia M. Lemp, Jan-Walter De Neve, Hermann Bussmann, Simiao Chen, Jennifer Manne-Goehler, Michaela Theilmann, Maja-Emilia Marcus, Cara Ebert, Charlotte Probst, Lindiwe Tsabedze-Sibanyoni, Lela Sturua, Joseph M. Kibachio, Sahar Saeedi Moghaddam, Joao S. Martins, Dismand Houinato, Corine Houehanou, Mongal S. Gurung, Gladwell Gathecha, Farshad Farzadfar, Scott Dryden-Peterson, Justine I. Davies, Rifat Atun, Sebastian Vollmer, Till Brnighausen, Pascal Geldsetzer
Issue&Volume: 2020/10/20
Abstract:
Importance The World Health Organization is developing a global strategy to eliminate cervical cancer, with goals for screening prevalence among women aged 30 through 49 years. However, evidence on prevalence levels of cervical cancer screening in low- and middle-income countries (LMICs) is sparse.
Objective To determine lifetime cervical cancer screening prevalence in LMICs and its variation across and within world regions and countries.
Design, Setting, and Participants Analysis of cross-sectional nationally representative household surveys carried out in 55 LMICs from 2005 through 2018. The median response rate across surveys was 93.8% (range, 64.0%-99.3%). The population-based sample consisted of 1136289 women aged 15 years or older, of whom 6885 (0.6%) had missing information for the survey question on cervical cancer screening.
Exposures World region, country; countries’ economic, social, and health system characteristics; and individuals’ sociodemographic characteristics.
Main Outcomes and Measures Self-report of having ever had a screening test for cervical cancer.
Results Of the 1129404 women included in the analysis, 542475 were aged 30 through 49 years. A country-level median of 43.6% (interquartile range [IQR], 13.9%-77.3%; range, 0.3%-97.4%) of women aged 30 through 49 years self-reported to have ever been screened, with countries in Latin America and the Caribbean having the highest prevalence (country-level median, 84.6%; IQR, 65.7%-91.1%; range, 11.7%-97.4%) and those in sub-Saharan Africa the lowest prevalence (country-level median, 16.9%; IQR, 3.7%-31.0%; range, 0.9%-50.8%). There was large variation in the self-reported lifetime prevalence of cervical cancer screening among countries within regions and among countries with similar levels of per capita gross domestic product and total health expenditure. Within countries, women who lived in rural areas, had low educational attainment, or had low household wealth were generally least likely to self-report ever having been screened.
Conclusions and Relevance In this cross-sectional study of data collected in 55 low- and middle-income countries from 2005 through 2018, there was wide variation between countries in the self-reported lifetime prevalence of cervical cancer screening. However, the median prevalence was only 44%, supporting the need to increase the rate of screening.
DOI: 10.1001/jama.2020.16244
Source: https://jamanetwork.com/journals/jama/article-abstract/2771901
JAMA-Journal of The American Medical Association：《美国医学会杂志》，创刊于1883年。隶属于美国医学协会，最新IF：157.335
官方网址：https://jamanetwork.com/
投稿链接：http://manuscripts.jama.com/cgi-bin/main.plex
本期文章：《美国医学会杂志》：Vol 324 No 15
