European urology · 2000
Glide wires for delayed catheterization of severely obstructed ureters.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Tali Hayuehashi, Yeerjiang Kunayimu, Zeng Bei Bei, Rui Tang, Musha Buajier, Wang Yan
Аннотация
OBJECTIVE: To investigate cervical cancer screening knowledge, attitudes, and practices among high-risk women in remote western China, and to identify socioeconomic and systemic barriers influencing screening participation. Additionally, to evaluate the comparative effectiveness of p16 staining versus p16/Ki-67 dual-staining immunocytochemistry in triaging women with cytological abnormalities or HPV-positive results, aiming to reduce unnecessary colposcopy referrals in resource-limited settings.
METHODS: This cross-sectional study enrolled 260 women (aged 20-65 years) with cytological abnormalities or HPV-positive results from two remote counties in Xinjiang Province (January-December 2023). Participants completed structured questionnaires assessing cervical cancer knowledge, screening attitudes, and healthcare access. Cervical specimens collected via liquid-based cytology underwent parallel testing: conventional cytology, p16 staining, and p16/Ki-67 dual-staining, with all analyses performed by blinded pathologists.
RESULTS: Among 260 high-risk women in Xinjiang, cervical cancer awareness (67.31%, 95% CI [61.50-72.90]) and screening rates (56.15%, 95% CI [50.23-62.17]) remained suboptimal. Multivariable analyses revealed significant disparities: college-educated women had 7.58-fold higher odds of awareness (95% CI [2.32-24.75]) compared to those with primary education, while public servants showed the strongest employment-based association (aOR = 11.23, 95% CI [2.64-47.83]). Mediation analysis demonstrated that health awareness fully mediated the effect of education (128.8% mediation) and nearly fully mediated the effect of employment (93.8%). Notably, 93.98% (95% CI [90.85-96.27]) expressed willingness to rescreen, and 82.95% (95% CI [78.33-86.84]) supported HPV vaccination. Biomarker analysis showed that p16/Ki-67 dual-staining positivity increased progressively with lesion severity (P < 0.001).
CONCLUSION: This study reveals suboptimal cervical cancer knowledge and screening rates among women in Xinjiang, with socioeconomic disparities-particularly in education and employment-primarily mediated through health awareness. The findings support integrated interventions, including physician-led education, digital health communication for media-dependent populations, simplified visual materials for less-educated women, and active linkage to national screening programs for unemployed populations. High rescreening willingness and parental acceptance of HPV vaccination indicate strong potential for intervention. p16 staining and p16/Ki-67 dual-staining show promise for triage in resource-limited settings. These findings highlight the need for tailored strategies to enhance cervical cancer prevention in western China, with further research needed to address current limitations.
METHODS: This cross-sectional study enrolled 260 women (aged 20-65 years) with cytological abnormalities or HPV-positive results from two remote counties in Xinjiang Province (January-December 2023). Participants completed structured questionnaires assessing cervical cancer knowledge, screening attitudes, and healthcare access. Cervical specimens collected via liquid-based cytology underwent parallel testing: conventional cytology, p16 staining, and p16/Ki-67 dual-staining, with all analyses performed by blinded pathologists.
RESULTS: Among 260 high-risk women in Xinjiang, cervical cancer awareness (67.31%, 95% CI [61.50-72.90]) and screening rates (56.15%, 95% CI [50.23-62.17]) remained suboptimal. Multivariable analyses revealed significant disparities: college-educated women had 7.58-fold higher odds of awareness (95% CI [2.32-24.75]) compared to those with primary education, while public servants showed the strongest employment-based association (aOR = 11.23, 95% CI [2.64-47.83]). Mediation analysis demonstrated that health awareness fully mediated the effect of education (128.8% mediation) and nearly fully mediated the effect of employment (93.8%). Notably, 93.98% (95% CI [90.85-96.27]) expressed willingness to rescreen, and 82.95% (95% CI [78.33-86.84]) supported HPV vaccination. Biomarker analysis showed that p16/Ki-67 dual-staining positivity increased progressively with lesion severity (P < 0.001).
CONCLUSION: This study reveals suboptimal cervical cancer knowledge and screening rates among women in Xinjiang, with socioeconomic disparities-particularly in education and employment-primarily mediated through health awareness. The findings support integrated interventions, including physician-led education, digital health communication for media-dependent populations, simplified visual materials for less-educated women, and active linkage to national screening programs for unemployed populations. High rescreening willingness and parental acceptance of HPV vaccination indicate strong potential for intervention. p16 staining and p16/Ki-67 dual-staining show promise for triage in resource-limited settings. These findings highlight the need for tailored strategies to enhance cervical cancer prevention in western China, with further research needed to address current limitations.