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2024年济南市妇女参与乳腺癌和宫颈癌联合筛查意愿及其影响因素分析

Willingness to participate in combined breast and cervical cancer screening and its influencing factors among 35–64 year old women participating in screening in Jinan city, 2024: a cross-sectional survey

  • 摘要:
    目的 调查山东省济南市妇女对乳腺癌、宫颈癌(两癌)筛查的认知及满意度情况,分析其对两癌联合筛查的参与意愿及影响因素,为两癌联合筛查模式的推广提供参考。
    方法 采用横断面调查研究方法,于2024年5—7月在山东省济南市对招募的社区参与两癌筛查的569名35~64岁妇女进行问卷调查,收集基本信息、对两癌筛查的认知情况、对联合筛查的参与意愿以及满意度情况,采用χ2检验、二元logistic回归方法进行统计分析。
    结果 共收集到有效问卷541份,其中87.43%的研究对象知晓政府定期为适龄妇女提供免费两癌筛查政策,分别有93.16%和80.78%的研究对象知晓乳腺癌和宫颈癌筛查方案中推荐的至少一种筛查方法,其中对乳腺体检、乳腺超声、乳腺X线检查的知晓率分别为79.11%、66.54%、10.35%;对HPV检测、细胞学检测、阴道镜检查的知晓率分别为74.86%、34.01%、29.57%。针对联合筛查模式,77.63%的研究对象倾向于“一次完成两种筛查”的联合筛查模式,17.74%的研究对象倾向于选择“两种筛查分开完成”的模式。多因素logistic回归结果显示,职业(OR=2.63,95%CI=1.11~6.23)和对两癌筛查的知晓情况(OR=6.29,95%CI=3.80~10.40)为参与联合筛查意愿的独立影响因素。在筛查时间和地点方面,99.26%的研究对象希望每1~3年内参与1次两癌筛查,71.90%的研究对象表示愿意在附近的社区卫生服务中心或乡镇卫生院完成筛查。在支付意愿方面,有53.05%的研究对象在完全自费情况下依然愿意选择联合筛查。大多数研究对象对所参与的筛查满意,对流程安排、医务人员的技术水平、服务态度非常满意的分别占73.94%、73.57%、72.83%,且98.89%的研究对象均认为前来参与筛查便利。
    结论 大部分妇女对两癌筛查有一定了解,且愿意参与联合筛查,但仍要重视对妇女的健康宣教;联合筛查对大多数妇女来说是一种更受欢迎的模式,但其在不同地区推广的可行性还需多角度的研究证据支持。

     

    Abstract:
    Objective To investigate the awareness and satisfaction of women in Jinan, Shandong Province, regarding breast and cervical cancer screening programs, and to analyze their willingness to participate in combined screening for both cancers and the influencing factors, with the aim of providing a reference for promoting combined screening for these cancers.
    Methods Using cross-sectional survey methods with a self-developed questionnaire, face-to-face interviews were conducted with 569 women aged 35–64 years in Jinan city, Shandong province, from May to July 2024. Participants were recruited through community-based cervical and breast cancer screening programs. The survey collected data on demographic characteristics, awareness of dual- cancer screening, willingness to participate in combined screening, and satisfaction. Data were analyzed using chi-squared tests and binary logistic regression.
    Results A total of 541 valid responses were received. Of the respondents, 87.43% were aware that the government regularly provides free screening for two cancers for women of appropriate age. In addition, 93.16% and 80.78% of respondents were aware of at least one recommended screening method for breast and cervical cancer programs, respectively. For breast cancer screening, awareness of specific methods was as follows: breast examination (79.11%), breast ultrasound (66.54%), and mammography (10.35%). For cervical cancer screening, awareness rates were: HPV testing (74.86%), cytology testing (34.01%), and colposcopy (29.57%). Regarding screening preferences, 77.63% of subjects preferred a single-visit model ("complete both screenings at the same time"), while 17.74% preferred separate visits. Multiple logistic regression identified two independent factors influencing willingness to participate in joint screening: occupation (odds ratio OR=2.63, 95% confidence interval 95%CI: 1.11–6.23) and prior awareness of screening (OR=6.29, 95%CI: 3.80–10.40). Regarding logistics, 99.26% of subjects preferred screening every 1–3 years and 71.90% preferred nearby community health centers. Even with full self-payment, 53.05% remained willing to choose community screening. Satisfaction rates were high: 73.94% (process arrangement), 73.57% (technical level of staff), and 72.83% (service attitude). Finally, 98.89% reported that it was convenient to participate.
    Conclusions While most women demonstrate awareness and willingness to participate in combined breast and cervical cancer screening, targeted health education remains necessary. Further research is needed to assess the feasibility of implementing this model in different regional settings.

     

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