Tran Nguyen Toan, Choe Song Il, Taylor Richard, Ko Won Suk, Pyo Hae Suk, So Hyon Chol
International Planned Parenthood Association, East Southeast Asia and Oceania Regional Office (IPPF ESEAOR), Kuala Lumpur, Malaysia.
Asian Pac J Cancer Prev. 2011;12(11):3029-33.
This study assessed women from the Democratic People's Republic of Korea for: (i) their level of knowledge of cervical cancer and attitudes and practices concerning cervical screening (KAP); and (ii) differences in KAP between rural and urban groups.
In a descriptive cross-sectional study, a purposive sample of 200 women in 6 provinces of DPRK (rural: n=99, urban: n=101) were interviewed using a standardized questionnaire. Differences between proportions were assessed using the χ2 test. Significance was defined as p<0.05.
63% of rural and 60% of urban participants had heard of cervical cancer (p>0.05). 42% knew that it is the most common cancer of the female reproductive tract, 55% knew that all women are at risk, but only 36% were aware of cervical cancer's preventability. Some 13% of rural and 29% of urban respondents had heard of cervical cytology testing (p<0.001). Only 6% of participants had ever received a cervical cytology smear. Among the reasons for not screening, 48% mentioned a lack of awareness of cervical cytology; 47% their dislike of pelvic examinations; 17% of rural and 31% of urban interviewees reported the absence of symptoms (p<0.05); and 62% of rural and 0% of urban women mentioned travelling long distances to service delivery points (p<0.001).
There is a reasonable level of knowledge of cervical cancer among North Korean women; however, there are major gaps regarding awareness of its preventability and actual uptake of cytology screening services. There are no significant differences between rural and urban women with regard to their KAP. Large scale health promotion campaigns are needed to educate women and the community about cervical cancer and its preventability through screening. The national health care system needs to ensure that screening services are effective, accessible, feasible and acceptable to women.
本研究对朝鲜女性进行了以下评估：（i）她们对宫颈癌的了解程度以及对宫颈癌筛查的态度和行为（知识、态度与行为）；（ii）农村和城市群体在知识、态度与行为方面的差异。
在一项描述性横断面研究中，采用标准化问卷对朝鲜6个省份的200名女性进行了目的抽样访谈（农村：n = 99，城市：n = 101）。使用χ²检验评估比例差异。显著性定义为p<0.05。
63%的农村参与者和60%的城市参与者听说过宫颈癌（p>0.05）。42%的人知道它是女性生殖道最常见的癌症，55%的人知道所有女性都有风险，但只有36%的人意识到宫颈癌是可预防的。约13%的农村受访者和29%的城市受访者听说过宫颈细胞学检测（p<0.001）。只有6%的参与者接受过宫颈细胞学涂片检查。在未进行筛查的原因中，48%提到对宫颈细胞学缺乏认识；47%表示不喜欢盆腔检查；17%的农村受访者和31%的城市受访者表示没有症状（p<0.05）；62%的农村女性和0%的城市女性提到前往服务提供点路途遥远（p<0.001）。
朝鲜女性对宫颈癌有一定程度的了解；然而，在对其可预防性的认识以及实际进行细胞学筛查服务方面存在重大差距。农村和城市女性在知识、态度与行为方面没有显著差异。需要开展大规模的健康促进活动，向女性和社区宣传宫颈癌及其通过筛查的可预防性。国家医疗保健系统需要确保筛查服务对女性有效、可及、可行且可接受。
