Viens Laura, Perin Doug, Senkomago Virginia, Neri Antonio, Saraiya Mona
Division of Cancer Prevention and Control, CDC, Atlanta, Georgia .
J Womens Health (Larchmt). 2017 May;26(5):403-412. doi: 10.1089/jwh.2017.6441.
United Nation's Sustainable Development Goals and the World Health Organization's Global Monitoring Framework support a strong global commitment to reducing the high burden of cervical and breast cancers among low- and middle-income countries. Strategies include vaccination, screening, and early diagnosis. Population-based surveys, such as those conducted by the Demographic and Health Surveys (DHS) Program, can collect the information needed to guide cancer control efforts in a standardized comparable manner. We identified and evaluated the breadth of breast and cervical cancer screening information that was collected by the DHS from 1984 through 2015. Then, we determined if these surveys currently provide the specific and measurable data about both the quantity and quality of cancer screening needed to guide national efforts to reduce the overall effects of cervical and breast cancers. We searched the DHS website to identify surveys conducted between the start of the DHS Program in 1984 and November 2015 that included questions about breast and cervical cancer screening. The relevant questions were extracted from the questionnaire, translated into English, and grouped by themes. Of the 90 countries where DHS surveys have been implemented, cervical cancer screening questions were included in 22 countries (24.4%) and breast cancer screening questions in 18 countries (20.0%). The common themes identified were disease knowledge, screening knowledge, screening practice, and screening outcomes. Most countries with survey questionnaires available for review addressed at least one aspect of screening practice (88.9% of cervical and 87.5% of breast), although few countries queried knowledge and outcomes. Questions that assess varied aspects of breast and cervical cancer screening have been incorporated into relatively few DHS surveys. The themes identified could guide the design of a standard set of questions for use in future population-based surveys and enable evaluation beyond the existence of screening, which would include assessment of the quality and impact of cervical and breast cancer screening.
联合国可持续发展目标和世界卫生组织全球监测框架支持全球做出坚定承诺，以减轻低收入和中等收入国家宫颈癌和乳腺癌的沉重负担。策略包括疫苗接种、筛查和早期诊断。基于人群的调查，如人口与健康调查（DHS）项目所开展的调查，能够以标准化且可比的方式收集指导癌症控制工作所需的信息。我们识别并评估了DHS在1984年至2015年期间收集的乳腺癌和宫颈癌筛查信息的广度。然后，我们确定这些调查目前是否提供了有关癌症筛查数量和质量的具体且可衡量的数据，以指导各国努力减少宫颈癌和乳腺癌的总体影响。我们在DHS网站上搜索，以识别在1984年DHS项目启动至2015年11月期间开展的、包含乳腺癌和宫颈癌筛查问题的调查。相关问题从问卷中提取出来，翻译成英文，并按主题进行分组。在实施了DHS调查的90个国家中，22个国家（24.4%）的调查问卷包含宫颈癌筛查问题，18个国家（20.0%）包含乳腺癌筛查问题。确定的共同主题包括疾病知识、筛查知识、筛查实践和筛查结果。大多数有调查问卷可供审查的国家至少涉及了筛查实践的一个方面（宫颈癌方面为88.9%，乳腺癌方面为87.5%），尽管很少有国家询问知识和结果。评估乳腺癌和宫颈癌筛查不同方面的问题仅被纳入了相对较少的DHS调查中。所确定的主题可为未来基于人群的调查设计一套标准问题提供指导，并能够在筛查存在情况之外进行评估，这将包括对宫颈癌和乳腺癌筛查的质量和影响的评估。
