Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA.
BMJ Open. 2020 Oct 12;10(10):e039464. doi: 10.1136/bmjopen-2020-039464.
Breast cancer is the most prevalent cancer and the second leading cause of cancer-related deaths among women after cervical cancer in much of sub-Saharan Africa. This study aims to examine the prevalence and sociodemographic-socioeconomic factors associated with breast cancer screening among women of reproductive age in sub-Saharan Africa.
A weighted population-based cross-sectional study using Demographic and Health Surveys (DHS) data. We used all available data on breast cancer screening from the DHS for four sub-Saharan African countries (Burkina Faso, Ivory Coast, Kenya and Namibia). Breast cancer screening was the outcome of interest for this study. Multivariable Poisson regression was used to identify independent factors associated with breast cancer screening.
Four countries participating in the DHS from 2010 to 2014 with data on breast cancer screening.
Women of reproductive age 15-49 years (N=39 646).
The overall prevalence of breast cancer screening was only 12.9% during the study period, ranging from 5.2% in Ivory Coast to 23.1% in Namibia. Factors associated with breast cancer screening were secondary/higher education with adjusted prevalence ratio (adjusted PR)=2.33 (95% CI: 2.05 to 2.66) compared with no education; older participants, 35-49 years (adjusted PR=1.73, 95% CI : 1.56 to 1.91) compared with younger participants 15-24 years; health insurance coverage (adjusted PR=1.57, 95% CI: 1.47 to 1.68) compared with those with no health insurance and highest socioeconomic status (adjusted PR=1.33, 95% CI : 1.19 to 1.49) compared with lowest socioeconomic status.
Despite high breast cancer mortality rates in sub-Saharan Africa, the prevalence of breast cancer screening is substantially low and varies gradually across countries and in relation to factors such as education, age, health insurance coverage and household wealth index level. These results highlight the need for increased efforts to improve the uptake of breast cancer screening in sub-Saharan Africa.
在撒哈拉以南非洲地区，乳腺癌是最常见的癌症，也是仅次于宫颈癌的女性癌症相关死亡的第二大原因。本研究旨在调查撒哈拉以南非洲育龄妇女乳腺癌筛查的流行情况和与社会人口经济学因素的相关性。
一项使用人口动态调查（Demographic and Health Surveys，DHS）数据的加权人群横断面研究。我们使用了来自撒哈拉以南非洲四个国家（布基纳法索、科特迪瓦、肯尼亚和纳米比亚）的 DHS 中关于乳腺癌筛查的所有可用数据。乳腺癌筛查是本研究的关注结果。多变量泊松回归用于确定与乳腺癌筛查相关的独立因素。
2010 年至 2014 年期间参与 DHS 的四个国家，这些国家都有乳腺癌筛查数据。
15-49 岁的育龄妇女（N=39646）。
在研究期间，乳腺癌筛查的总体流行率仅为 12.9%，范围从科特迪瓦的 5.2%到纳米比亚的 23.1%。与未接受教育的人群相比，接受过中等/高等教育的人群（调整后患病率比，adjusted prevalence ratio，aPR=2.33；95%可信区间，confidence interval，CI：2.05 至 2.66）、35-49 岁的参与者（aPR=1.73；95%CI：1.56 至 1.91）与 15-24 岁的参与者相比、有医疗保险的人群（aPR=1.57；95%CI：1.47 至 1.68）与没有医疗保险的人群相比、社会经济地位最高的人群（aPR=1.33；95%CI：1.19 至 1.49）与社会经济地位最低的人群相比，乳腺癌筛查的可能性更高。
尽管撒哈拉以南非洲的乳腺癌死亡率很高，但乳腺癌筛查的流行率仍然很低，并且在国家之间以及与教育、年龄、医疗保险覆盖范围和家庭财富指数水平等因素存在差异。这些结果突出表明，需要加大努力，提高撒哈拉以南非洲地区乳腺癌筛查的普及率。
