河南省城市地区乳腺癌筛查依从性及其影响因素分析

目的 评价2013—2019年河南省城市地区乳腺癌高危人群筛查依从性并探索可能的影响因素。方法 选取河南省40~74岁城市户籍居民进行癌症危险因素调查和乳腺癌风险评估。对于乳腺癌高危人群,40~44岁者行乳腺超声检查;45岁以上者,行乳腺超声联合X线摄影(钼靶)检查。比较不同特征人群的乳腺癌筛查参与率并分析乳腺癌筛查参与率的影响因素。结果 本研究共纳入符合研究要求的乳腺癌高危人群29 111例,其中13 760例接受了乳腺癌筛查,总体参与率为47.27%。乳腺癌筛查的参与率存在着显著的地区和时间差异:最高和最低城市的参与率分别为74.24%和 40.00%;2013—2014年度的总体筛查参与率最低为40.66%,2017—2018年度的总体筛查参与率最高为51.05%。多因素Logistic回归分析提示,45~64岁、具有初中及以上学历、正在吸烟或既往吸烟、正在饮酒或既往饮酒、体育锻炼缺乏、初潮年龄＜12岁、已绝经、有生育史、有乳腺良性疾病史、有乳腺癌家族史和有卵巢癌家族史的人群更愿意接受乳腺癌筛查。结论 我省城市乳腺癌高危人群的乳腺癌筛查参与率不足48%,未来需针对特定人群采取措施提升乳腺癌筛查的总体依从性。

Analysis of compliance with breast cancer screening and its influencing factors in urban areas of Henan province

Objective The objective of this study was to evaluate the compliance of breast cancer screening among high-risk population in urban areas of Henan province from 2013 to 2019 and explore possible influencing factors. Methods The urban residents aged 40~74 years old in Henan province were selected for cancer risk factor survey and breast cancer risk assessment.For people at high risk of breast cancer,breast ultrasound examination was performed for those aged 40~45 years old,and breast ultrasound combined with X-ray photography(molybdenum target)examination for those over 45 years old.The participation rate of breast cancer screening among people with different characteristics was compared and further analyzed its influencing factors. Results A total of 29,111 cases of breast cancer high-risk population that met the research requirements were included in the study,of which 13,760 cases were screened for breast cancer,and the overall participation rate was 47.27%.There were significant regional and time differences in the participation rate of breast cancer screening:the participation rates in the highest and lowest cities were 74.24% and 40.00%,respectively;the overall screening participation rate from 2013 to 2014 was the lowest 40.66% and the highest 51.05% from 2017 to 2018.The multivariate logistic regression analyses suggested:45~64 years old,with junior high school degree or above,smoking or smoking in the past,drinking or drinking in the past,lack of physical exercise,menarche age ＜12 years,menopause,history of fertility,history of benign breast disease,a family history of breast cancer,and a family history of ovarian cancer were more willing to accept breast cancer screening. Conclusion The overall participation rate of breast cancer screening among high-risk population of urban breast cancer in Henan province is less than 48%.The measures should be taken for specific populations to improve the overall compliance of breast cancer screening in the future.