School of Social Sciences, Western Sydney University, Penrith, New South Wales, 2751, Australia.
Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia.
BMC Public Health. 2020 Sep 29;20(1):1467. doi: 10.1186/s12889-020-09557-w.
Breast cancer is one of the leading public health problem globally, especially in low-resource countries (LRCs). Breast cancer screening (BCS) services are an effective strategy for early determining of breast cancer. Hence, it is imperative to understand the utilisation of BCS services and their correlated predictors in LRCs. This study aims to determine the distribution of predictors that significantly influence the utilisation of BCS services among women in LRCs.
The present study used data on 140,974 women aged 40 years or over from 14 LRCs. The data came from country Demographic and Health Surveys (DHS) between 2008 and 2016. Multivariate logistic regression analysis was employed to investigate the significant predictors that influence the use of BCS services.
The utilisation of BCS services was 15.41%, varying from 81.10% (95% CI: 76.85-84.73%) in one European country, to 18.61% (95% CI: 18.16 to 19.06%) in Asian countries, 14.30% (95% CI: 13.67-14.96%) in American countries, and 14.29% (95% CI: 13.87-14.74%). Factors that were significantly associated to increase the use of BCS services include a higher level of education (OR = 2.48), advanced age at first birth (> 25 years) (OR = 1.65), female-headed households (OR = 1.65), access to mass media communication (OR = 1.84), health insurance coverage (OR = 1.09), urban residence (OR = 1.20) and highest socio-economic status (OR = 2.01). However, obese women shown a significantly 11% (OR = 0.89) lower use of BSC services compared to health weight women.
The utilisation of BCS services is low in many LRCs. The findings of this study will assist policymakers in identifying the factors that influence the use of BCS services. To increase the national BCS rate, more attention should be essential to under-represented clusters; in particular women who have a poor socioeconomic clusters, live in a rural community, have limited access to mass media communication, and are have a low level educational background. These factors highlight the necessity for a new country-specific emphasis of promotional campaigns, health education, and policy targeting these underrepresented groups in LRCs.
乳腺癌是全球主要的公共卫生问题之一，尤其是在资源匮乏国家（LRCs）。乳腺癌筛查（BCS）服务是早期发现乳腺癌的有效策略。因此，了解 LRCs 中 BCS 服务的利用情况及其相关预测因素至关重要。本研究旨在确定显著影响 LRCs 中妇女 BCS 服务利用的预测因素分布。
本研究使用了来自 14 个 LRCs 的 140974 名 40 岁及以上妇女的数据。数据来自 2008 年至 2016 年期间的国家人口与健康调查（DHS）。采用多变量逻辑回归分析探讨影响 BCS 服务利用的显著预测因素。
BCS 服务的利用率为 15.41%，从一个欧洲国家的 81.10%（95%CI：76.85-84.73%）到亚洲国家的 18.61%（95%CI：18.16-19.06%），再到美洲国家的 14.30%（95%CI：13.67-14.96%），再到 LRCs 的 14.29%（95%CI：13.87-14.74%）。显著增加 BCS 服务利用的因素包括更高的教育水平（OR=2.48）、初产年龄较大（>25 岁）（OR=1.65）、女性为户主的家庭（OR=1.65）、接触大众媒体（OR=1.84）、健康保险覆盖（OR=1.09）、城市居住（OR=1.20）和最高社会经济地位（OR=2.01）。然而，与健康体重的女性相比，肥胖女性的 BCS 服务利用率显著降低了 11%（OR=0.89）。
许多 LRCs 中 BCS 服务的利用率较低。本研究的结果将有助于政策制定者确定影响 BCS 服务利用的因素。为了提高国家 BCS 率，应特别关注代表性不足的群体；特别是社会经济地位较差、生活在农村社区、接触大众媒体机会有限、教育程度较低的妇女。这些因素强调了在 LRCs 中针对这些代表性不足的群体开展新的、有针对性的宣传活动、健康教育和政策的必要性。
