Comparisons of Papanicolaou Utilization and Cervical Cancer Detection between Rural and Urban Women in Taiwan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Statistical Analysis
3. Results
3.1. Baseline Characteristics of Study Population
3.2. Incidence of Cervical Cancer
3.3. Nested Case-Control Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Taichung City Pap Smear Test | Yunlin County Pap Smear Test | p-Value | |||||||
---|---|---|---|---|---|---|---|---|---|
No N = 2267 (18.7%) | Yes N = 9859 (81.3%) | No N = 1005 (13.9%) | Yes N = 6224 (86.1%) | ||||||
Age in 1996 | n | (%) | n | (%) | n | (%) | n | (%) | <0.0001 |
20–29 yrs | 783 | (34.5) | 3518 | (35.7) | 276 | (27.5) | 1545 | (24.8) | |
30–49 | 920 | (40.6) | 5021 | (50.9) | 361 | (35.9) | 2882 | (46.3) | |
50–64 | 404 | (17.8) | 1128 | (11.4) | 239 | (23.8) | 1462 | (23.5) | |
≥65 | 160 | (7.06) | 192 | (1.95) | 129 | (12.8) | 335 | (5.38) | |
p-value | <0.0001 | <0.0001 | |||||||
Outpatient visits | <0.0001 | ||||||||
0–9 | 1134 | (50.0) | 1980 | (20.1) | 470 | (46.8) | 1107 | (17.8) | |
10–19 | 573 | (25.3) | 3771 | (38.3) | 270 | (26.9) | 2174 | (34.9) | |
20–29 | 301 | (13.3) | 2190 | (22.2) | 139 | (13.8) | 1471 | (23.6) | |
30+ | 259 | (11.4) | 1918 | (19.5) | 126 | (12.5) | 1472 | (23.7) | |
p-value | <0.0001 | <0.0001 | |||||||
Income, NTD | <0.0001 | ||||||||
<20,000 | 1723 | (76.0) | 7034 | (71.4) | 583 | (58.0) | 3403 | (54.7) | |
20,000–39,999 | 433 | (19.1) | 2048 | (20.8) | 388 | (38.6) | 2486 | (39.9) | |
≥40,000 | 111 | (4.90) | 777 | (7.88) | 34 | (3.38) | 335 | (5.38) | |
p-value | <0.0001 | 0.01 |
Taichung City | None Screening | Pap Screening | RR (95% CI) | |||
---|---|---|---|---|---|---|
Case | Rate | Case | Rate | Crude | Adjusted | |
n | (per 1000) | n | (per 1000) | |||
Age in 1996 | ||||||
20–29 years | 3 | (3.83) | 7 | (1.99) | 0.52 (0.13–2.01) | 0.59 (0.14–2.51) |
30–49 | 21 | (22.8) | 45 | (8.96) | 0.39 (0.23–0.66) | 0.35 (0.20–0.59) |
50–64 | 16 | (39.6) | 14 | (12.4) | 0.31 (0.15–0.64) | 0.28 (0.14–0.59) |
≥65 | 6 | (37.5) | 3 | (15.6) | 0.42 (0.10–1.67) | 0.35 (0.08–1.24) |
Outpatient visits | ||||||
0–9 | 11 | (9.70) | 10 | (5.05) | 0.52 (0.22–1.23) | 0.61 (0.25–1.47) |
10–19 | 11 | (19.2) | 30 | (7.96) | 0.41 (0.21–0.83) | 0.65 (0.31–1.36) |
20–29 | 7 | (23.3) | 17 | (7.76) | 0.33 (0.14–0.80) | 0.46 (0.17–1.20) |
30+ | 17 | (65.6) | 12 | (6.26) | 0.10 (0.05–0.20) | 0.10 (0.05–0.22) |
Income | ||||||
<20,000 | 28 | (16.3) | 53 | (7.53) | 0.46 (0.29–0.73) | 0.54 (0.34–0.88) |
20,000–39,999 | 15 | (34.6) | 11 | (5.37) | 0.16 (0.07–0.34) | 0.16 (0.07–0.35) |
≥40,000 | 3 | (27.0) | 5 | (6.44) | 0.24 (0.06–0.99) | 0.18 (0.04–0.79) |
Total | 46 | (20.3) | 69 | (7.00) | 0.34 (0.24–0.50) | 0.38 (0.25–0.56) |
Yunlin County | ||||||
Age in 1996 | ||||||
20–29 years | 2 | (7.25) | 6 | (3.88) | 0.54 (0.11–2.66) | 0.49 (0.09–2.68) |
30–49 | 14 | (38.8) | 31 | (10.8) | 0.28 (0.15–0.52) | 0.27 (0.14–0.52) |
50–64 | 15 | (62.8) | 12 | (8.21) | 0.13 (0.06–0.28) | 0.12 (0.06–0.27) |
≥65 | 5 | (38.8) | 7 | (20.9) | 0.54 (0.17–1.70) | 0.55 (0.17–1.74) |
Outpatient visits | ||||||
0–9 | 7 | (14.9) | 10 | (9.03) | 0.61 (0.23–1.59) | 0.68 (0.25–1.81) |
10–19 | 7 | (25.9) | 18 | (8.28) | 0.32 (0.13–0.76) | 0.41 (0.17–0.99) |
20–29 | 7 | (50.4) | 14 | (9.52) | 0.19 (0.08–0.47) | 0.21 (0.08–0.54) |
30+ | 15 | (119.0) | 14 | (9.51) | 0.08 (0.04–0.17) | 0.07 (0.03–0.15) |
Income | ||||||
<20,000 | 17 | (29.2) | 34 | (9.99) | 0.34 (0.19–0.61) | 0.30 (0.16–0.54) |
20,000–39,999 | 18 | (46.4) | 18 | (7.24) | 0.16 (0.08–0.30) | 0.17 (0.09–0.32) |
≥40,000 | 1 | (29.4) | 4 | (11.9) | 0.41 (0.05–3.63) | 0.47 (0.05–4.75) |
Total | 36 | (35.8) | 56 | (9.00) | 0.25 (0.17–0.38) | 0.25 (0.17–0.39) |
Controls N = 828 | Cases N = 207 | Total N = 1035 | Univariable | Multivariable | ||||||
---|---|---|---|---|---|---|---|---|---|---|
n | (%) | n | % | n | % | OR | (95% CI) | OR | (95% CI) | |
Pap screening | ||||||||||
No | 158 | (19.1) | 82 | (39.6) | 240 | (23.2) | 1.00 | (reference) | 1.00 | (reference) |
Yes | 570 | (80.9) | 125 | (60.4) | 729 | (76.9) | 0.42 | (0.26–0.50) | 0.35 | (0.25–0.51) |
Age in 1996 | ||||||||||
20–29 | 281 | (33.9) | 18 | (8.70) | 299 | (28.9) | 1.00 | (reference) | 1.00 | (reference) |
30–49 | 395 | (47.7) | 111 | (53.6) | 506 | (48.9) | 4.39 | (2.58–7.26) | 3.93 | (2.48–7.40) |
50–64 | 120 | (14.5) | 57 | (27.5) | 177 | (17.1) | 7.42 | (4.70–9.23) | 6.45 | (4.11–8.72) |
≥65 | 32 | (3.86) | 21 | (10.1) | 53 | (5.12) | 10.2 | (4.20–23.8) | 7.01 | (3.21–18.7) |
Outpatient visits | ||||||||||
0–9 | 208 | (25.1) | 38 | (18.4) | 246 | (23.8) | 1.00 | (reference) | 1.00 | (reference) |
10–19 | 289 | (34.9) | 66 | (31.9) | 355 | (34.3) | 1.25 | (0.81–1.94) | 1.56 | (0.96–2.52) |
20–29 | 174 | (21.0) | 45 | (21.7) | 219 | (21.2) | 1.42 | (0.88–2.28) | 1.47 | (0.87–2.50) |
30+ | 157 | (19.0) | 58 | (28.0) | 215 | (20.8) | 2.02 | (1.28–3.20) | 1.42 | (0.85–2.36) |
Income | ||||||||||
<20,000 | 557 | (67.3) | 132 | (63.8) | 689 | (66.6) | 1.00 | (reference) | 1.00 | (reference) |
20,000–39,999 | 221 | (26.7) | 62 | (30.0) | 283 | (27.3) | 1.18 | (0.84–1.66) | 0.89 | (0.61–1.30) |
≥40,000 | 50 | (6.04) | 13 | (6.28) | 63 | (6.09) | 1.10 | (0.58–2.08) | 1.13 | (0.58–2.22) |
Area | ||||||||||
Taichung city | 540 | (65.2) | 115 | (55.6) | 655 | (63.3) | 1.00 | (reference) | 1.00 | (reference) |
Yunlin County | 288 | (34.8) | 92 | (44.4) | 380 | (36.7) | 1.50 | (1.10–2.04) | 1.46 | (1.03–2.06) |
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Yang, C.-M.; Sung, F.-C.; Hsue, C.-S.; Muo, C.-H.; Wang, S.-W.; Shieh, S.-H. Comparisons of Papanicolaou Utilization and Cervical Cancer Detection between Rural and Urban Women in Taiwan. Int. J. Environ. Res. Public Health 2021, 18, 149. https://doi.org/10.3390/ijerph18010149
Yang C-M, Sung F-C, Hsue C-S, Muo C-H, Wang S-W, Shieh S-H. Comparisons of Papanicolaou Utilization and Cervical Cancer Detection between Rural and Urban Women in Taiwan. International Journal of Environmental Research and Public Health. 2021; 18(1):149. https://doi.org/10.3390/ijerph18010149
Chicago/Turabian StyleYang, Chiu-Ming, Fung-Chang Sung, Chao-Song Hsue, Chih-Hsin Muo, Shu-Wei Wang, and Shwn-Huey Shieh. 2021. "Comparisons of Papanicolaou Utilization and Cervical Cancer Detection between Rural and Urban Women in Taiwan" International Journal of Environmental Research and Public Health 18, no. 1: 149. https://doi.org/10.3390/ijerph18010149