Penn State College of Medicine, Department of Public Health Sciences, Hershey, PA, United States.
Penn State College of Medicine, Department of Public Health Sciences, Hershey, PA, United States.
Cancer Epidemiol. 2021 Jun;72:101930. doi: 10.1016/j.canep.2021.101930. Epub 2021 Mar 20.
Cervical cancer is the fourth most common cancer among women worldwide, with an estimate of 570,000 new cases and about 311,000 deaths annually. Low-resource countries, including those in sub-Saharan Africa, have the highest-burden with an estimate of 84 % of all cervical cancers. This study examines the prevalence and socio-demographic-economic factors associated with cervical cancer screening in sub-Saharan Africa.
A weighted population-based cross-sectional study using Demographic and Health Surveys data. We used available data on cervical cancer screening between 2011 and 2018 from the Demographic and Health Surveys for five sub-Saharan African countries (Benin, Ivory Coast, Kenya, Namibia, and Zimbabwe). The study population included women of childbearing age, 21-49 years (n = 28,976). We fit a multivariable Poisson regression model to identify independent factors associated with cervical cancer screening.
The overall weighted prevalence of cervical cancer screening was 19.0 % (95 % CI: 18.5 %-19.5 %) ranging from 0.7 % in Benin to 45.9 % in Namibia. Independent determinants of cervical cancer screening were: older age (40-49 years) adjusted prevalence ratio (aPR) = 1.77 (95 % CI: 1.64, 1.90) compared with younger age (21-29 years), secondary/higher education (aPR = 1.51, 95 CI: 1.28-1.79) compared with no education, health insurance (aPR = 1.53, 95 % CI: 1.44-1.61) compared with no insurance, and highest socioeconomic status (aPR = 1.39, 95 % CI: 1.26-1.52) compared with lowest.
The prevalence of cervical cancer screening is substantially low in sub-Saharan Africa countries and shows a high degree of between-country variation. Interventions aimed at increasing the uptake of cervical cancer screening in sub-Saharan Africa are critically needed.
宫颈癌是全球女性中第四常见的癌症，每年估计有 57 万新发病例和约 31.1 万例死亡。包括撒哈拉以南非洲在内的资源匮乏国家的负担最重，估计所有宫颈癌中有 84%发生在这些国家。本研究旨在调查撒哈拉以南非洲地区宫颈癌筛查的流行情况和与社会人口经济因素的相关性。
采用基于人口的横断面研究，利用人口与健康调查数据。我们使用了 2011 年至 2018 年人口与健康调查中来自撒哈拉以南非洲五个国家（贝宁、科特迪瓦、肯尼亚、纳米比亚和津巴布韦）的宫颈癌筛查可用数据。研究人群包括 21-49 岁有生育能力的妇女（n=28976）。我们拟合了多变量泊松回归模型，以确定与宫颈癌筛查相关的独立因素。
宫颈癌筛查的总加权流行率为 19.0%（95%CI：18.5%-19.5%），范围从贝宁的 0.7%到纳米比亚的 45.9%。宫颈癌筛查的独立决定因素包括：年龄较大（40-49 岁）调整后的患病率比（aPR）为 1.77（95%CI：1.64，1.90），与年龄较小（21-29 岁）相比；中等/高等教育（aPR=1.51，95%CI：1.28-1.79）与无教育相比；医疗保险（aPR=1.53，95%CI：1.44-1.61）与无保险相比；以及最高社会经济地位（aPR=1.39，95%CI：1.26-1.52）与最低相比。
撒哈拉以南非洲国家的宫颈癌筛查普及率很低，且各国之间存在很大差异。迫切需要采取干预措施，以提高撒哈拉以南非洲地区的宫颈癌筛查率。
