中国城市乳腺癌高危人群筛查依从性及其相关因素分析

目的 评价中国城市乳腺癌高危人群筛查依从性并分析与其相关的因素。方法 以2013—2018年中国20个省份开展的城市癌症早诊早治项目中,获得的399 869例乳腺癌高危人群资料用于数据分析。所有符合城市癌症早诊早治项目研究条件的参与者均接受风险评估问卷调查以评估患癌风险,并推荐评估结果为乳腺癌高危的人群在项目指定医院进行相应筛查(乳腺超声和/或乳腺钼靶)。采用χ²检验比较不同特征人群的乳腺癌筛查参与率差异;采用多因素Logistic回归模型研究与乳腺癌筛查参与率相关的因素。结果 399 869例乳腺癌高危人群中,221 268例接受了乳腺癌筛查,参与率为55.3%。根据国家统计局地区分类标准,中国东部(55.7%,81 999/147 209)、中部(59.9%,76 368/127 594)、西部(50.3%,62 901/125 066)地区乳腺癌筛查参与率差异显著(χ²=2 347.3,P＜0.001)。多因素Logistic回归分析结果显示,50~59岁、目前仍在吸烟、目前戒烟、具有高中以上学历、二手烟暴露、绝闭经、曾分娩、曾患良性乳腺疾病、有血缘亲属曾患乳腺癌、有血缘亲属曾患卵巢癌的高危人群更易接受乳腺癌筛查;60~74岁、少数民族、经常参加体育锻炼、有哺乳史的高危人群更不易接受乳腺癌筛查。结论 中国20个省份乳腺癌高危人群筛查总体参与率较低。年龄、受教育程度、民族、吸烟史、二手烟暴露史、体育锻炼、绝闭经、分娩史、哺乳史、良性乳腺疾病史、血缘亲属乳腺癌史和血缘亲属卵巢癌史是与乳腺癌筛查依从性相关的重要因素。

Analysis of screening compliance and related factors in high-risk populations of breast cancer in Chinese cities

Objective The aim of this study was to evaluate the compliance of breast cancer screening among high-risk population in Chinese cities and analyze its related factors. Methods The data of 399,869 high-risk breast cancer patients in the urban cancer early diagnosis and treatment project carried out in 20 provinces in China from 2013 to 2018 were used for data analysis.All participants who met the research conditions of the Urban Cancer Early Diagnosis and Treatment Project were received a risk assessment questionnaire to assess the risk of cancer,and it was recommended that people whose assessment results were at high risk of breast cancer undergo corresponding screening(breast ultrasound and/or mammography).Chi-square tests were used to compare the differences in breast cancer screening participation rates among groups of different characteristics;Multivariate logistic regression models were used to explore the potential factors related to breast cancer screening participation rates. Results Among the 399,869 high-risk groups of breast cancer,221,268 participants received breast cancer screening,with a participation rate of 55.3%.According to the regional classification standards of the National Bureau of Statistics,breast cancer screening in the eastern China(55.7%,81,999/147,209),central(59.9%,76,368/127,594),and western(50.3%,62,901/125,066)regions.The participation rates were significant difference(χ²=2347.3,P＜0.001).The results of multivariate logistic regression analyses showed that 50~59 years old,still smoking,and currently quit smoking,an education with high school degree or above,secondhand smoke exposure,menopausal,reproductive history,a history of benign breast diseases,family history of breast or ovarian cancer were more likely to accept breast cancer screening.High-risk populations who were 60~74 years old,ethnic minorities,often participate in physical exercise,and had a history of breastfeeding were less likely to receive breast cancer screening. Conclusion The overall participation rate of screening of high-risk breast cancer populations in 20 provinces in China is low.Age,education,Ethnicity smoking,exposure to second-hand smoke physical activity,menopause,history of childbirth,breastfeeding history,benign breast disease,family history of breast or ovarian cancer are important factors related to breast cancer screening compliance.