| Titre : | Does screening history explain the ethnic differences in stage at diagnosis of cervical cancer in New Zealand ? (2010) |
| Auteurs : | Naomi BREWER ; Barry BORMAN ; Lis ELLISON-LOSCHMANN ; JEFFREYS (Mona) : GBR. Department of Social Medicine. University of Bristol. Bristol. ; Neil PEARCE |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 39, n° 1, 2010) |
| Pagination : | 156-165 |
| Langues: | Anglais |
| Mots-clés : | Cancer ; Dépistage ; Histoire ; Historique ; Ethnie ; Etude comparée ; Diagnostic ; Utérus ; Océanie ; Appareil génital femelle |
| Résumé : | [BDSP. Notice produite par INIST-CNRS GA9GR0xD. Diffusion soumise à autorisation]. Background There are ethnic disparities in cervical cancer survival in New Zealand. The objectives of this study were to assess the associations of screening history, ethnicity, socio-economic status (SES) and rural residence with stage at diagnosis in women diagnosed with cervical cancer in New Zealand during 1994-2005. Methods The 2323 cases were categorized as'ever screened'if they had had at least one smear prior to 6 months before diagnosis, and as'regular screening'if they had had no more than 36 months between any two smears in the period 6-114 months before diagnosis. Logistic regression was used to estimate the associations of screening history, ethnicity, SES and urban/rural residence with stage at diagnosis. Results The percentages'ever screened'were 43.3% overall, 24.8% in Pacific, 30.5% in Asian, 40.6% in Maori and 46.1% in'Other'women. The corresponding estimates for'regular screening'were 14.0,5.7,7.8,12.5 and 15.3%. Women with'regular screening'had a lower risk of late stage diagnosis [odds ratio (OR) 0.16,95% confidence interval (CI) 0.10-0.26], and the effect was greater for squamous cell carcinoma (OR 0.12,95% CI 0.07-0.23) than for adenocarcinoma (OR 0.32,95% CI 0.13-0.82). The increased risk of late-stage diagnosis (OR 2.72,95% CI 1.99-3.72) in Maori (compared with'Other') women decreased only slightly when adjusted for screening history (OR 2.45,95% CI 1.77-3.39). Conclusions Over half of cases had not been'ever screened'Regular screening substantially lowered the risk of being diagnosed at a late stage. However, screening history does not appear to explain the ethnic differences in stage at diagnosis. |
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