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Comparisons of Papanicolaou Utilization and Cervical Cancer Detection between Rural and Urban Women in Taiwan

Authors
  • Yang, Chiu-Ming1
  • Sung, Fung-Chang1, 2
  • Hsue, Chao-Song3, 4
  • Muo, Chih-Hsin
  • Wang, Shu-Wei3, 5
  • Shieh, Shwn-Huey1, 6
  • 1 (F.-C.S.)
  • 2 Department of Food Nutrition and Health Biotechnology, Asia University, Taichung 413, Taiwan
  • 3 (S.-W.W.)
  • 4 Feng Yuan Hospital, Ministry of Health and Welfare, Taichung 420, Taiwan
  • 5 School of Nursing, Kaohsiung Medical University, Kaohsiung 807, Taiwan
  • 6 Department of Nursing, Asia University, Taichung 41354, Taiwan
Type
Published Article
Journal
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Publication Date
Dec 28, 2020
Volume
18
Issue
1
Identifiers
DOI: 10.3390/ijerph18010149
PMID: 33379209
PMCID: PMC7795661
Source
PubMed Central
Keywords
Disciplines
  • Article
License
Green

Abstract

Using the claims data of one million insured residents in Taiwan from 1996–2013, this study identified 12,126 women in an urban city (Taichung) and 7229 women in a rural county (Yunlin), aged 20 and above. We compared Papanicolaou (Pap) test uses and cervical cancer detection rates between urban and rural women. Results showed that the Pap screening rate was slightly higher in rural women than in urban women (86.1 vs. 81.3 percent). The cervical cancer incidence was much greater for women without Pap test than women with the test (35.8 vs. 9.00 per 1000 in rural women and 20.3 vs. 7.00 per 1000 in urban women). Nested case-control analysis showed that Pap test receivers had an adjusted odds ratio (OR) of 0.35 (95% CI = 0.25–0.51) to be diagnosed with cervical cancer as compared to those who did not receive the test. The rural women had an adjusted OR of 1.46 (95% CI = 1.03–2.06) to be diagnosed with cervical cancer as compared to urban women. In conclusion, women in rural area are at higher cancer risk than city women. Women who do not undergo Pap tests deserve timely intervention of Pap test to prevent the onset of cancer, particularly in rural women with low income.

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