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秘鲁 2015 年 50 至 59 岁女性接受乳房 X 光筛查的社会决定因素。

Social determinants of mammography screening among women aged 50 to 59, Peru 2015.

机构信息

School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Perú.

National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.

出版信息

Health Care Women Int. 2021 Jan;42(1):92-106. doi: 10.1080/07399332.2020.1786093. Epub 2020 Jul 6.

Abstract

Breast cancer (BC) screening could reduce its mortality; however, its access is influenced by societal forces. Our objective is to identify the social determinants associated with mammography screening (MS) in women aged 50 to 59 in Peru. In this cross-sectional analysis of the Peruvian Demographic Health Survey, 2015, MS within the past two years was evaluated through self-report. Prevalence for MS was 21.9% [95% CI: 18.9 to 25.1]. The average age was 54 years (s.d.: 2.5). The higher the socioeconomic status, the higher the prevalence of screening (3.2% vs 41.4% in extreme quintiles,  < .001). In the adjusted models, higher socioeconomic status (PR: 5.81, 95% CI: 2.28 to 14.79), higher education level (PR: 2.03, 95% CI: 1.30 a 3,15) and having health insurance from the Ministry of Health (PR: 2.21, 95% CI: 1.28 to 3.82) and EsSalud (PR: 4.37, 95% CI: 2.67 to 7.15), were positively associated with MS. Social inequalities in screening access exist and might translate into inequalities in cancer morbidity and mortality. The Peruvian government urgently needs to improve screening rates in these vulnerable populations.

摘要

乳腺癌(BC)筛查可以降低其死亡率;然而,其可及性受到社会力量的影响。我们的目的是确定与秘鲁 50 至 59 岁女性乳房 X 线照片筛查(MS)相关的社会决定因素。在这项对 2015 年秘鲁人口健康调查的横断面分析中,通过自我报告评估了过去两年内的 MS 情况。MS 的患病率为 21.9%[95%CI:18.9 至 25.1]。平均年龄为 54 岁(标准差:2.5)。社会经济地位越高,筛查的患病率越高(在极端五分位数中,分别为 3.2%和 41.4%,<0.001)。在调整后的模型中,较高的社会经济地位(PR:5.81,95%CI:2.28 至 14.79)、较高的教育水平(PR:2.03,95%CI:1.30 至 3.15)以及拥有卫生部(PR:2.21,95%CI:1.28 至 3.82)和 EsSalud(PR:4.37,95%CI:2.67 至 7.15)的健康保险与 MS 呈正相关。筛查机会存在社会不平等,可能转化为癌症发病率和死亡率的不平等。秘鲁政府迫切需要提高这些弱势群体的筛查率。

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