Lemma Seifu Beminate, Mekuria Negussie Yohannes, Abrham Asnake Angwach, Daba Chinkey Fraol, Melak Fente Bezawit, Alamrie Asmare Zufan
Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Department of Medicine, Adama General Hospital and Medical College, Adama, Ethiopia.
PLoS One. 2024 Dec 27;19(12):e0312831. doi: 10.1371/journal.pone.0312831. eCollection 2024.
Breast cancer is a significant global health issue, responsible for a large number of female cancer deaths. Early detection through breast cancer screening is crucial in reducing mortality rates. However, regions such as Sub-Saharan Africa (SSA) face challenges in identifying breast cancer early, resulting in higher mortality rates and a lower quality of life. Yet, there is a noticeable gap in the literature concerning breast cancer screening. Thus, this study aimed to estimate the pooled prevalence of breast cancer screening and associated factors among women of reproductive age in SSA.
A weighted sample of 80,058 reproductive-age women from recent Demographic and Health Surveys in SSA countries was considered for analysis. A multilevel modified Poisson regression model with robust variance was fitted to identify factors associated with breast cancer screening. Four nested models were fitted, and the model with the lowest deviance value was selected. An adjusted prevalence ratio with the corresponding 95% confidence interval was used to measure the strength of the association. Finally, statistical significance was declared at a p-value < 0.05.
The pooled prevalence of breast cancer screening among reproductive-age women in SSA was 11.35% (95% CI: 11.14%, 11.56%), with variations ranging from 4.95% (95% CI: 4.61%, 5.30%) in Tanzania to 24.70% (95% CI: 24.06%, 25.33%) in Burkina Faso. Age (20-24, 25-29, 30-34, 35-39, 40-44, and 45-49 years), secondary and higher education, wealth index, media exposure, parity, contraceptive use, pregnancy status, breastfeeding status, and visiting a healthcare facility in the last 12 months were identified as significant positive determinants of breast cancer screening. Conversely, being a rural resident and having a primary education level were found to be negative determinants.
This study uncovers a low prevalence of breast cancer screening in SSA countries, despite high associated mortality rates. Emphasizing the significance of targeted interventions, it highlights the crucial need to promote education and awareness regarding the benefits of breast cancer screening, particularly in light of the challenges faced by many women in the region.
乳腺癌是一个重大的全球健康问题，导致大量女性癌症死亡。通过乳腺癌筛查进行早期检测对于降低死亡率至关重要。然而，撒哈拉以南非洲（SSA）等地区在早期发现乳腺癌方面面临挑战，导致死亡率较高且生活质量较低。然而，关于乳腺癌筛查的文献存在明显空白。因此，本研究旨在估计SSA育龄妇女乳腺癌筛查的合并患病率及相关因素。
考虑对来自SSA国家近期人口与健康调查的80,058名育龄妇女的加权样本进行分析。拟合了一个具有稳健方差的多级修正泊松回归模型，以确定与乳腺癌筛查相关的因素。拟合了四个嵌套模型，并选择偏差值最低的模型。使用调整后的患病率比及其相应的95%置信区间来衡量关联强度。最后，p值<0.05时宣布具有统计学意义。
SSA育龄妇女乳腺癌筛查的合并患病率为11.35%（95%CI：11.14%，11.56%），范围从坦桑尼亚的4.95%（95%CI：4.61%，5.30%）到布基纳法索的24.70%（95%CI：24.06%，25.33%）。年龄（20 - 24岁、25 - 29岁、30 - 34岁、35 - 39岁、40 - 44岁和45 - 49岁）、中等及高等教育、财富指数、媒体曝光、产次、避孕措施使用、妊娠状态、母乳喂养状态以及过去12个月内就诊于医疗机构被确定为乳腺癌筛查的显著正向决定因素。相反，农村居民和小学教育水平被发现是负向决定因素。
本研究发现，尽管SSA国家乳腺癌相关死亡率较高，但乳腺癌筛查的患病率较低。强调了有针对性干预措施的重要性，突出了促进关于乳腺癌筛查益处的教育和意识的迫切需求，特别是鉴于该地区许多妇女面临的挑战。
