Kangmennaang Joseph, Mkandawire Paul, Luginaah Isaac
Department of Geography and Environment, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1.
The Institute of Interdisciplinary Studies, 2201 Dunton Tower, 1125 Colonel By Drive, Ottawa, ON, Canada K1S 5B6.
J Cancer Epidemiol. 2016;2016:7962502. doi: 10.1155/2016/7962502. Epub 2016 Jan 10.
Objectives. Although a growing body of evidence demonstrates the public health burden of prostate cancer in SSA, relatively little is known about the underlying factors surrounding the low levels of testing for the disease in the context of this region. Using Namibia Demographic Health Survey dataset (NDHS, 2013), we examined the factors that influence men's decision to screen for prostate cancer in Namibia. Methods. We use complementary log-log regression models to explore the determinants of screening for prostate cancer. We also corrected for the effect of unobserved heterogeneity that may affect screening behaviours at the cluster level. Results. The results show that health insurance coverage (OR = 2.95, p = 0.01) is an important predictor of screening for prostate cancer in Namibia. In addition, higher education and discussing reproductive issues with a health worker (OR = 2.02, p = 0.05) were more likely to screening for prostate cancer. Conclusions. A universal health insurance scheme may be necessary to increase uptake of prostate cancer screening. However it needs to be acknowledged that expanded screening can have negative consequences and any allocation of scarce resources towards screening must be guided by evidence obtained from the local context about the costs and benefits of screening.
目标。尽管越来越多的证据表明撒哈拉以南非洲地区前列腺癌的公共卫生负担，但对于该地区该疾病检测水平较低背后的因素，人们了解相对较少。利用纳米比亚人口与健康调查数据集（2013年纳米比亚人口与健康调查），我们研究了影响纳米比亚男性进行前列腺癌筛查决策的因素。方法。我们使用互补对数-对数回归模型来探究前列腺癌筛查的决定因素。我们还校正了可能在聚类层面影响筛查行为的未观察到的异质性的影响。结果。结果表明，医疗保险覆盖（比值比=2.95，p=0.01）是纳米比亚前列腺癌筛查的一个重要预测因素。此外，受过高等教育以及与医护人员讨论生殖问题（比值比=2.02，p=0.05）的人更有可能进行前列腺癌筛查。结论。可能需要一个全民医疗保险计划来提高前列腺癌筛查的接受度。然而，需要认识到扩大筛查可能会有负面后果，并且任何将稀缺资源用于筛查的分配都必须以从当地背景获得的关于筛查成本和效益的证据为指导。
