Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.
Centre for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam.
PLoS One. 2022 May 27;17(5):e0269228. doi: 10.1371/journal.pone.0269228. eCollection 2022.
This study examined current breast cancer (BC) screening practices among Vietnamese women and the factors associated with the uptake of clinical breast examination (CBE).
A total of 508 women aged 30-74 years in Hanoi completed a knowledge-attitude-practice (KAP) survey in 2019 including validated measures of breast cancer awareness (Breast-CAM) and health beliefs (Champion's Health Belief Model Scale). Descriptive statistics, χ2, and ANOVA tests were used to analyse KAP responses across groups with different sociodemographic characteristics. A logistic regression model assessed the associations of knowledge, beliefs, and sociodemographic characteristics with CBE uptake.
Only 18% of respondents were aware of BC signs, risk factors, and screening modalities although 63% had previously received BC screening. CBE was the most common screening modality with an uptake of 51%. A significantly higher proportion of urban residents compared with rural residents (32% vs 18%, Chi-square test, p = 0.04) received mammography. Unlike mammography, CBE uptake was not associated with sociodemographic characteristics (i.e., residence area/education level/occupation/household monthly income/possession of health insurance). CBE uptake was associated with BC knowledge (OR = 2.44, 95%CI: 1.37-4.32), perceived susceptibility to BC (OR = 1.15, 95%CI: 1.05-1.25), and perceived barriers to accessing CBE (OR = 0.88, 95%CI: 0.84-0.92).
The study points to the need for public health education and promotion interventions to address low levels of awareness about BC and to increase uptake of BC screening in Vietnam in advance of screening programme planning and implementation. It also suggests that screening programmes using CBE are promising given current engagement and the absence of socio-demographic disparities.
本研究考察了越南女性当前的乳腺癌（BC）筛查实践以及与临床乳房检查（CBE）接受度相关的因素。
2019 年，河内共有 508 名年龄在 30-74 岁的女性完成了一项知识-态度-实践（KAP）调查，其中包括经过验证的乳腺癌意识（Breast-CAM）和健康信念（Champion 的健康信念模型量表）测量方法。使用描述性统计、卡方检验和方差分析检验了不同社会人口统计学特征组的 KAP 应答情况。逻辑回归模型评估了知识、信念和社会人口统计学特征与 CBE 接受度的关联。
尽管 63%的受访者之前接受过乳腺癌筛查，但仅有 18%的受访者知晓乳腺癌的体征、危险因素和筛查方式。CBE 是最常见的筛查方式，接受率为 51%。与农村居民相比，城市居民接受乳房 X 线摄影术的比例明显更高（32%比 18%，卡方检验，p=0.04）。与乳房 X 线摄影术不同，CBE 接受度与社会人口统计学特征（即居住地区/教育水平/职业/家庭月收入/是否拥有医疗保险）无关。CBE 接受度与乳腺癌知识（OR=2.44，95%CI：1.37-4.32）、对乳腺癌的易感性感知（OR=1.15，95%CI：1.05-1.25）和获得 CBE 的障碍感知（OR=0.88，95%CI：0.84-0.92）有关。
该研究表明，需要开展公共卫生教育和促进干预措施，以提高越南对乳腺癌的认识，并在规划和实施筛查计划之前提高乳腺癌筛查的接受度。鉴于目前的参与度和缺乏社会人口统计学差异，使用 CBE 的筛查计划具有很大的潜力。
