Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China.
School of Media, Communication and Sociology, University of Leicester, Leicester LE1 7RH, UK.
Int J Environ Res Public Health. 2022 Jul 6;19(14):8237. doi: 10.3390/ijerph19148237.
To evaluate the attendance and determinants of organized cervical and breast cancer (two-cancer) screening, especially higher-level factors, we conducted a cross-sectional survey in central China from June 2018 to November 2019 among 1949 women (age ≥ 35 years). We examined organizer-level factors, provider-level factors, receiver-lever factors and attendance and participation willingness of screening. The results indicate that the attendance and participation willingness of organized two-cancer screening was 61.19% and 77.15%, respectively. After adjustment for potential confounders, women who received screening notification were more likely to have greater participation willingness and higher attendance than those who received no notification (adjusted odds ratio [aOR] = 1.59, 95% confidence interval [CI]: 1.27-1.99; aOR = 98.03, 95% CI: 51.44-186.82, respectively). Compared with being notified about screening by GPs, being notified by community women's leaders and other community leaders were more likely to lead to greater willingness to participate again (aOR = 2.86, 95% CI: 1.13-7.24; aOR = 3.27, 95% CI: 1.26-8.48, respectively) and recommending screening to others (aOR = 2.18, 95% CI: 1.02-4.65; aOR = 4.14, 95% CI: 1.84-9.30, respectively). The results suggest that notification of women about screening by community leaders is an important organizer-level factor. As a part of public health services, the design and implementation of optimal cancer screening strategies may require public-sector involvement at the organizer level instead of a one-man show by the health sector.
为了评估组织的宫颈癌和乳腺癌（两癌）筛查的参与度和决定因素，特别是更高层次的因素，我们于 2018 年 6 月至 2019 年 11 月在中国中部对 1949 名（年龄≥35 岁）妇女进行了一项横断面调查。我们检查了组织者层面的因素、提供者层面的因素、接受者层面的因素以及筛查的参与度和参与意愿。结果表明，组织两癌筛查的参与度和参与意愿分别为 61.19%和 77.15%。在调整了潜在的混杂因素后，与未收到通知的妇女相比，收到筛查通知的妇女更有可能具有更大的参与意愿和更高的参与率（调整后的优势比[aOR] = 1.59，95%置信区间[CI]：1.27-1.99；aOR = 98.03，95%CI：51.44-186.82）。与由全科医生通知筛查相比，由社区妇女领袖和其他社区领袖通知更有可能导致再次参与的意愿更强（aOR = 2.86，95%CI：1.13-7.24；aOR = 3.27，95%CI：1.26-8.48），并向他人推荐筛查（aOR = 2.18，95%CI：1.02-4.65；aOR = 4.14，95%CI：1.84-9.30）。结果表明，由社区领袖通知妇女进行筛查是一个重要的组织者层面的因素。作为公共卫生服务的一部分，制定和实施最佳癌症筛查策略可能需要公共部门在组织者层面的参与，而不是卫生部门的独角戏。
