Factors Associated With Adherence of Cervical Cancer Screening in Women With Systemic Lupus Erythematosus

IF 3.7 2区医学 Q1 RHEUMATOLOGY

Arthritis Care & Research Pub Date : 2024-04-29 DOI:10.1002/acr.25355

Sebastian Bruera, Savannah Bowman, Yinan Huang, Maria E. Suarez-Almazor, Grace H. Lo, Maria Lopez-Olivo, Elizabeth Chiao, Jennifer R. Kramer, Fred A. Pereira, Sandeep K. Agarwal

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Abstract

Objective

The objective is to determine cervical cancer screening rates and factors associated with decreased cervical cancer screening in women with systemic lupus erythematosus (SLE).

Methods

We conducted a cross-sectional study that enrolled consecutive women (age 21–64 years) with SLE. We collected demographics, clinical characteristics, constructs of the Health Beliefs Model (HBM) (ie, susceptibility, severity, barriers, benefits, cues to action, and self-efficacy), and self-reported cervical cancer screening (confirmed with the electronic medical record). The primary outcome was adherence to cervical cancer screening according to current guidelines. Multivariable logistic regression models were used to examine the association between SLE disease activity and cervical cancer screening and explore mediation effects from HBM constructs.

Results

We enrolled 130 women with SLE. The median age was 42 years (interquartile range 32–52 years). The cervical cancer screening adherence rate was 61.5%. Women with high SLE disease activity were less likely to have cervical cancer screening versus those with low disease activity (odds ratio 0.59, 95% confidence interval [CI] 0.39–0.89; P = 0.01), which remained statistically significant after adjusting for baseline demographics and drug therapy in a multivariable model (odds ratio 0.25, 95% CI 0.08–0.79; P = 0.02). Regarding the HBM constructs, increased perceived barriers to cervical cancer screening (r = −0.30, P < 0.01) and decreased self-efficacy (r = −0.21, P = 0.02) correlated with decreased cervical cancer screening.

Conclusion

Patients with SLE with high disease activity undergo cervical cancer screening less frequently than those with low disease activity. Perceived barriers to cervical cancer screening are moderately correlated with decreased screening. These data highlight the need to develop strategies to increase cervical cancer screening in this high-risk patient population.

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系统性红斑狼疮妇女坚持宫颈癌筛查的相关因素

目的确定系统性红斑狼疮（SLE）女性患者的宫颈癌筛查率以及与宫颈癌筛查率下降相关的因素。方法我们进行了一项横断面研究，连续招募了多名系统性红斑狼疮女性患者（21-64 岁）。我们收集了人口统计学、临床特征、健康信念模型（HBM）的构建（即易感性、严重性、障碍、益处、行动提示和自我效能）以及自我报告的宫颈癌筛查情况（通过电子病历确认）。主要结果是根据现行指南坚持进行宫颈癌筛查。我们使用多变量逻辑回归模型来研究系统性红斑狼疮疾病活动与宫颈癌筛查之间的关系，并探索 HBM 结构的中介效应。中位年龄为 42 岁（IQR 32-52）。宫颈癌筛查的坚持率为 61.5%。系统性红斑狼疮疾病活动度高的妇女与疾病活动度低的妇女相比，接受宫颈癌筛查的可能性较低（OR 0.59，0.39-0.89，p=0.01），在多变量模型中对基线人口统计学和药物治疗进行调整后，这一结果仍具有统计学意义（OR 0.25，95% CI 0.08-0.79，p=0.02）。结论疾病活动度高的系统性红斑狼疮患者接受宫颈癌筛查的频率低于疾病活动度低的患者。宫颈癌筛查的认知障碍与筛查率下降呈中度相关。这些数据突出表明，有必要制定相关策略，以增加这一高风险患者群体的宫颈癌筛查率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthritis Care & Research RHEUMATOLOGY-

CiteScore

9.40

自引率

6.40%

发文量

368

审稿时长

3-6 weeks

期刊介绍： Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.