Division of Surgical Oncology Department of Surgery, Faculty of Medicine Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.
PILAR Research and Education, 20 Station Road, Cambridge, CB1 2JD, UK.
BMC Cancer. 2018 Mar 6;18(1):208. doi: 10.1186/s12885-018-4125-z.
Cancer screening awareness and participation may be lower in low- and middle-income countries that lack established national screening programmes compared with those that do. We evaluated potential determinants of awareness about and participation in breast and cervical cancer screening, and breast self-examination (BSE) in women using survey data from Indonesia.
From the fifth Indonesian Family Life Survey (2014-2015), a total of 5397 women aged 40 and older without any history of cancer who responded to questionnaires concerning Pap smears, mammography, and BSE were included. Multilevel modelling was used to assess potential determinants in relation to awareness about Pap smears and mammography, and participation in Pap smears and BSE practice. Multivariable analyses were performed to identify independent predictors of cancer screening.
Of the 5397 respondents, 1058 (20%) women were aware of Pap smears, of which 297 had never had the procedure. Only 251 (5%) participants were aware of mammography. A total of 605 (12%) of women reported they performed BSE. Higher education and household expenditure were consistently associated with higher odds of awareness about Pap smears and mammography (e.g. odds ratio [OR] of being aware of Pap smear and mammography: 7.82 (95% CI: 6.30-9.70) and 7.70 (6.19-9.58), respectively, for high school graduates compared to women with less educational attainment in the multivariable models), and participation in Pap smears and BSE. We also identified enabling factors linked with greater cancer screening awareness and participation, including health insurance, shorter distance to health services, and social participation.
There are socioeconomic disparities in cancer screening awareness and participation among Indonesian women. Our findings may help inform targeted health promotion and screening for cancer in the presence of limited resources.
与已建立国家筛查计划的国家相比，缺乏既定国家筛查计划的中低收入国家的癌症筛查意识和参与度可能较低。我们使用来自印度尼西亚的调查数据评估了 50 岁及以上女性对乳腺癌和宫颈癌筛查以及乳房自我检查（BSE）的意识和参与的潜在决定因素。
来自第五次印度尼西亚家庭生活调查（2014-2015 年），共有 5397 名无癌症史的年龄在 40 岁及以上的女性对有关巴氏涂片、乳房 X 光检查和 BSE 的问卷做出了回应。使用多水平模型评估与巴氏涂片和乳房 X 光检查意识以及巴氏涂片和 BSE 实践参与相关的潜在决定因素。进行多变量分析以确定癌症筛查的独立预测因素。
在 5397 名受访者中，有 1058 名（20%）女性了解巴氏涂片检查，其中 297 名从未进行过该检查。只有 251 名（5%）参与者了解乳房 X 光检查。共有 605 名（12%）女性报告进行了 BSE。较高的教育程度和家庭支出与对巴氏涂片和乳房 X 光检查的意识较高相关（例如，在多变量模型中，对巴氏涂片和乳房 X 光检查有较高意识的可能性比：7.82（95%CI：6.30-9.70）和 7.70（6.19-9.58），分别为高中毕业生与受教育程度较低的女性），以及巴氏涂片和 BSE 的参与度。我们还确定了与更高的癌症筛查意识和参与度相关的促成因素，包括健康保险、距离卫生服务的距离较短和社会参与。
印度尼西亚女性的癌症筛查意识和参与度存在社会经济差异。我们的研究结果可能有助于在资源有限的情况下为癌症筛查提供有针对性的健康促进和宣传。
