Assuntos
Assistência Ambulatorial/organização & administração , COVID-19 , Gastroenterologia/tendências , Pacientes não Comparecentes , Telemedicina , Atitude Frente a Saúde , Austrália/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Alfabetização Digital , Estresse Financeiro , Humanos , Controle de Infecções , Competência em Informação , Modelos Organizacionais , Pacientes não Comparecentes/economia , Pacientes não Comparecentes/psicologia , Pacientes não Comparecentes/estatística & dados numéricos , SARS-CoV-2 , Fatores Socioeconômicos , Telemedicina/métodos , Telemedicina/organização & administraçãoRESUMO
Nova Scotia, and especially Cape Breton, has high cervical cancer incidence and mortality rates. Letters were sent to 15,691 unscreened and 6,995 under-screened women from Cape Breton Island encouraging them to obtain a Pap test. Controls were 61,510 unscreened women and 32,996 under- screened women in mainland Nova Scotia who were not sent letters. For this cohort study, the provincial Health Card Number database and Provincial Cytology Registry were linked. Having a Pap smear was associated with having received a letter (OR = 1.64), having been previously under-screened rather than unscreened (OR = 1.85), with youth and with higher income (OR = 1.13). After receiving a letter, women in Aboriginal, Mixed Black, Acadian, and rural communities had smear rates similar to those of other women. Being previously unscreened, rather than under-screened, was associated with higher rates of abnormalities (OR = 1.62), indicating greater need for early detection and treatment to prevent invasive cancer. While one-time letters to women improved the Pap smear screening rates, multiple, continuous interventions are needed to make a more substantive improvement in these rates.
