Al Rifai Rami, Nakamura Keiko
Department of International Health and Medicine, Division of Public Health, Tokyo Medical and Dental University, Tokyo, Japan E-mail :
Asian Pac J Cancer Prev. 2015;16(15):6697-704. doi: 10.7314/apjcp.2015.16.15.6697.
The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan.
A nationwide population- based cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years.
Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening.
The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.
在发展中国家，乳腺癌和宫颈癌的负担随时间不断变化。定期筛查对于早期发现和治疗非常重要。在本研究中，我们根据家庭财富状况评估了女性乳腺癌和宫颈癌筛查率的不平等情况，并分析了约旦癌症筛查率低的潜在预测因素。
一项基于全国人口的横断面调查收集了国家层面不同变量的信息。所有年龄在15 - 49岁的曾婚女性（本文中该表述用于指代曾结婚的女性）均纳入调查。对11,068名女性进行了前一年至少一次乳房自我检查（BSE）和临床乳房检查（CBE）的分析，同时对8,333名年龄在20 - 49岁的女性进行了一生中的巴氏涂片检查。
超过39%的约旦曾婚女性报告在前一年接受过乳房检查，19%的女性报告一生中至少接受过一次巴氏涂片检查。前一年乳房自我检查率为31.5%，临床乳房检查率为19.3%，一生中至少进行一次巴氏涂片检查的比例为25.5%。与最低财富指数五分位数组的女性相比，最高财富指数五分位数组的女性进行乳房自我检查（调整后比值比[aOR] 1.22，95%置信区间[CI] 1.04 - 1.43）、临床乳房检查（aOR 1.31，95% CI 1.08 - 1.60）和巴氏涂片检查（aOR 2.38，95% CI 1.92 - 2.93）的调整后比值比更高。乳房自我检查的集中指数为0.11，临床乳房检查为0.01，巴氏涂片检查为0.27。二十多岁、居住在约旦农村或南部地区、小学及以下学历、每年听广播或看报纸次数不超过几次的女性以及未生育女性接受乳腺癌和宫颈癌筛查的可能性较小。
约旦乳腺癌和宫颈癌的筛查率较低。减少乳腺癌和宫颈癌筛查中的社会人口学和经济不平等现象，需要针对生活在社会贫困条件下的女性开展协同的外展活动。
