宫颈癌筛查对农村妇女相关防治知识影响因素分析

目的了解北京市宫颈癌免费筛查前后对大兴区农村地区30～59岁妇女的宫颈癌防治知识知晓率的变化，探索其影响因素，以便制订相应防治策略。方法采用三阶段分层随机及按固定样本量分配样本数量选取研究对象，分别在北京市宫颈癌免费筛查启动的前一年（2008年）和启动年（2009年）对妇女宫颈癌防治知识进行横断面一对一方式的调查。结果单因素分析显示：在北京市宫颈癌免费筛查项目启动后，大兴区妇女宫颈癌总体知晓率显著提高，被调查的农村妇女宫颈癌相关知识总体知晓率有显著提高，答对5题以上的妇女比例从启动前的37．3％提高到51．0％（χ^2=62．06，P〈0．001）；在调整其他混杂因素后，多因素分析结果亦显示宫颈癌筛查有利于宫颈癌相关知识知晓率的提高（OR=1．853，95％CI：1．590～2．159）。此外，单因素分析显示，居住地、文化程度、家庭年人均收入、有否5年内筛查史是影响妇女知晓率的主要因素，且文化程度、家庭年人均收入等级越高，知晓率越高（DR值分别为1．766和2．580及OR值分别为1．350和1．676）。结论通过北京市免费筛查宫颈癌和健康教育宣传活动确实能够提高广大妇女宫颈癌防治知识水平，尤其是对于以往没有参加过筛查的群体，可以提高她们的参与意识。

Impacts of screening programme on awareness of control and prevention of cervical cancer in women living in rural areas

Objective To explore the influence of screening programme on awareness of cervical cancer prevention among 30 to 59 years old women who live in rural areas of Beijing. Methods A face-toface cross-sectional survey on women＇s knowledge on cervical cancer prevention was conducted in 2008 and 2009 among subjects recurited by three-stage stratified random sampling. Results Univariate analysis showed that since the initiation of cervical cancer screening in Daxing District of Beijing, the overall awareness of cervical cancer was significantly increased among women residents, and the percentage of women with 5 or more correct answers was increased from 37.3% to 51.0% （ χ^2= 62. 06, P 〈 0. 001 ）. After adjusting confounding factors, multivariate analysis showed that cervical cancer screening programme contributed to improved awareness of cervical cancer-related knowledge （ OR = 1. 853,95% CI 1. 590 -2. 159）. In addition, current place of residence, education level, household income per-capita and screening history within 5 years were major factors affecting women＇ s awareness of cervical cancer （ OR vales were 1. 766,2. 580, 1. 350 and 1. 676, respectively）, and higher education level and personal income were correlated with increased awareness rate. Conclusion Cervical cancer screening could improve general knowledge of cervical cancer, especially for those who have never participated in the screening programme.