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济南市女性对传统及即时检测宫颈癌筛查技术的认知及接受度:基于筛查人群的横断面调查

Awareness and acceptance of conventional and point-of-care technologies in cervical cancer screening among women in Jinan, China: a cross-sectional survey

  • 摘要:
    目的 调查山东省济南市女性对人乳头瘤病毒(HPV)、宫颈癌筛查的认知水平及即时检测(POCT)技术的接受度,分析其影响因素,了解该人群对POCT技术的满意度和推广态度。
    方法 采用横断面调查研究方法,于2024年5月—2025年6月,在济南市2个社区卫生服务中心中抽取参与两癌筛查的629名35~64岁女性研究对象进行问卷调查,收集基本情况、对HPV及宫颈癌筛查的认知情况、对POCT技术的接受度情况等信息,采用χ2检验、二元logistic回归方法进行统计分析。
    结果 共收集有效问卷629份。HPV及宫颈癌筛查认知方面,46.26%的女性知晓HPV,其中70.10%了解其为宫颈癌主要病因;80.76%的女性听说过宫颈癌筛查,其中仅有44.09%知晓具体筛查方法;HPV检测、细胞学检查、醋酸和卢戈氏碘液染色肉眼观察法(VIA/VILI)的知晓率分别为33.86%、24.61%、6.99%;多因素分析显示,与35~44岁组相比,55~64岁组HPV及宫颈癌筛查认知水平最低(OR=0.17,95%CI=0.10~0.31);与小学及以下学历组相比,大专及以上学历组认知水平最高(OR=3.71,95%CI=1.44~9.56)。POCT技术接受度方面,有55.96%的女性愿意未来在筛查中使用POCT技术;多因素分析显示,与小学及以下学历女性相比,高中组(OR=0.43,95%CI=0.22~0.81)和大专、本科及以上组(OR=0.37,95%CI=0.17~0.81)的接受度更高;与无业女性相比,自由职业者(OR=1.93,95%CI=1.08~3.42)和工人群体女性(OR=2.33,95%CI=1.10~4.92)对POCT技术的接受度更低。满意度与推广态度方面,84.27%的女性认为POCT技术能够显著节约时间、提高传统筛查效率,83.94%认为其能显著提高传统筛查的准确性,85.21%对其总体感到非常满意,83.78%对其长期应用持积极态度,83.62%会向其他人推荐使用该技术。
    结论 济南市女性对HPV和宫颈癌筛查已具备一定认知基础,但对具体筛查技术的了解仍有待提高。女性对POCT技术的接受度处于中等水平,但对其满意度和推广意愿较高。

     

    Abstract:
    Objective  To investigate the awareness levels of human papillomavirus (HPV) and cervical cancer screening, as well as the acceptance of point-of-care testing (POCT) technology among women in Jinan, Shandong province, analyze the influencing factors, and assess their satisfaction with and attitudes toward the promotion of POCT technology.
    Methods  A cross-sectional survey was conducted from May 2024 to June 2025 among 629 women aged 35–64 years who participated in the two-cancer screening program at two community health service centers in Jinan. Information on sociodemographic characteristics, awareness of HPV and cervical cancer screening, and acceptance of POCT technology was collected. Statistical analyses were performed with the chi-square test and binary logistic regression.
    Results  A total of 629 valid questionnaires were obtained. Regarding awareness of HPV and cervical cancer screening, 46.26% of participants had heard of HPV, among whom 70.10% knew it as the primary cause of cervical cancer. Overall, 80.76% had heard of cervical cancer screening, whereas only 44.09% were aware of specific screening methods. The awareness rates of HPV testing, cytological examination, and visual inspection with acetic acid/Lugol′s iodine (VIA/VILI) were 33.86%, 24.61%, and 6.99%, respectively. Multivariable analysis showed that compared with women aged 35–44 years, those aged 55–64 years had the lowest awareness level of HPV and cervical cancer screening (OR = 0.17, 95%CI: 0.10–0.31). Compared with women with primary school education or below, those with college education or above had the highest awareness level (OR = 3.71, 95%CI: 1.44–9.56). Regarding acceptance of POCT, 55.96% of women expressed willingness to use POCT in future screening. Multivariable analysis indicated that compared with women with primary school education or below, those with senior high school education (OR = 0.43, 95%CI: 0.22–0.81) and those with college or undergraduate education and above (OR = 0.37, 95%CI: 0.17–0.81) showed increased acceptance of POCT. Freelancers (OR = 1.93, 95%CI: 1.08–3.42) and workers (OR = 2.33, 95%CI: 1.10–4.92) showed lower acceptance of POCT technology than unemployed women. In terms of satisfaction and attitudes toward promotion, 84.27% of participants believed that POCT could significantly save time and improve the efficiency of conventional screening; 83.94% believed that it could significantly improve the accuracy of conventional screening; 85.21% reported being very satisfied overall; 83.78% held a positive attitude toward its long-term application; and 83.62% were willing to recommend the technology to others.
    Conclusions  Women in Jinan have established basic awareness of HPV and cervical cancer screening, while their understanding of specific screening technologies remains insufficient. Acceptance of POCT technology is at a moderate level, whereas satisfaction with and willingness to promote this technology are relatively high.

     

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