Gao Yanqing, Liang Guoxin, Chang Chun, Pan Feng, Huang Fumin, Gong Litong, Huang Liyu
Daxing Center for Disease Control and Prevention, Beijing, China.
Department of Social Medicine and Health Education, Peking University School of Public Health, Beijing, China.
PLoS One. 2025 Jan 24;20(1):e0316898. doi: 10.1371/journal.pone.0316898. eCollection 2025.
To clarify the screening behavior and influencing factors of females with breast cancer and cervical cancer in suburban areas and to provide a scientific basis for the subsequent implementation of targeted health education, intervention measures and the formulation of relevant policies.
This study used a multi-stage stratified random sampling method to select 4, 000 women in urban and rural areas of Beijing to analyze their behavior, basic situation, and influencing factors regarding cervical and breast cancer screening.
The sample size of the final included valid analysis was 3861 people, and the screening rate was 27.25% for cervical cancer, 20.64% for breast cancer, 30.46% for at least one screening and 17.43% for both cervical cancer and breast cancer screening. The rate of four screening conditions was greater in urban areas (PCervical cancer screening = 31.1%, PBreast cancer screening = 22.0%, PAt least one = 33.9%, PBoth cancers were screened = 19.1%) than in rural areas (PCervical cancer screening = 22.6%, PBreast cancer screening = 19.0%, PAt least one = 26.2%, PBoth cancers were screened = 15.4%) and was greater with medical insurance (PCervical cancer screening = 28.7%, PBreast cancer screening = 21.7%, PAt least one = 32.0%, PBoth cancers were screened = 18.5%) than without medical insurance (PCervical cancer screening = 12.8%, PBreast cancer screening = 10.3%, PAt least one = 15.6%, PBoth cancers were screened = 7.5%). The highest percentage of the four screening conditions was found in the 45-59-year-old group (PCervical cancer screening = 36.0%, PBreast cancer screening = 29.8%, PAt least one = 39.5%, PBoth cancers were screened = 26.4%). The rate of cervical cancer screening behavior increased with increasing education level and family per capita monthly income, and the highest percentage of respondents had a college education or above (PCervical cancer screening = 35.2%, PBreast cancer screening = 23.6%, PAt least one = 38.2%, PBoth cancers were screened = 20.6%), as did the percentage of families whose per capita monthly income was above 15, 000 yuan (PCervical cancer screening = 34.7%, PBreast cancer screening = 27.3%, PAt least one = 38.3%, PBoth cancers were screened = 23.6%). Multivariate analysis revealed that an age range of 45 to 59 years (PAll four screening conditions were obtained<0.001), an education level of junior high school, a high school (PAll four screening conditions were obtained<0.001), a college education or above (PAll four screening conditions were obtained<0.001), a marital status of a spouse (PAll four screening conditions were obtained<0.001), a divorce status (PAll four screening conditions were obtained<0.001) or a widowhood status (PAll four screening conditions were obtained<0.001), and a medical insurance status (PAll four screening conditions were obtained<0.001) were positively correlated with the percentages of the four screening behaviors.
The level of "two- cancer" screening behavior of suburban residents in Beijing still warrants improvement, and precision nutrition and health communication and intervention should be carried out continuously for rural residents, individuals under age 45, unmarried individuals, individuals with a primary school education and below, and people without medical insurance.
明确郊区乳腺癌和宫颈癌女性的筛查行为及影响因素，为后续实施针对性健康教育、干预措施及制定相关政策提供科学依据。
本研究采用多阶段分层随机抽样方法，选取北京市城乡4000名女性，分析其宫颈癌和乳腺癌筛查的行为、基本情况及影响因素。
最终纳入有效分析的样本量为3861人，宫颈癌筛查率为27.25%，乳腺癌筛查率为20.64%，至少进行一项筛查的比例为30.46%，同时进行宫颈癌和乳腺癌筛查的比例为17.43%。四种筛查情况的比例在城市地区（宫颈癌筛查P = 31.1%，乳腺癌筛查P = 22.0%，至少一项筛查P = 33.9%，两项癌症均筛查P = 19.1%）高于农村地区（宫颈癌筛查P = 22.6%，乳腺癌筛查P = 19.0%，至少一项筛查P = 26.2%，两项癌症均筛查P = 15.4%），且有医疗保险者（宫颈癌筛查P = 28.7%，乳腺癌筛查P = 21.7%，至少一项筛查P = 32.0%，两项癌症均筛查P = 18.5%）高于无医疗保险者（宫颈癌筛查P = 12.8%，乳腺癌筛查P = 10.3%，至少一项筛查P = 15.6%，两项癌症均筛查P = 7.5%）。四种筛查情况比例最高的是45 - 59岁年龄组（宫颈癌筛查P = 36.0%，乳腺癌筛查P = 29.8%，至少一项筛查P = 39.5%，两项癌症均筛查P = 26.4%）。宫颈癌筛查行为发生率随教育程度和家庭人均月收入的增加而升高，受访者中大学及以上学历者比例最高（宫颈癌筛查P = 35.2%，乳腺癌筛查P = 23.6%，至少一项筛查P = 38.2%，两项癌症均筛查P = 20.6%），家庭人均月收入高于15000元者比例也最高（宫颈癌筛查P = 34.7%，乳腺癌筛查P = 27.3%，至少一项筛查P = 38.3%，两项癌症均筛查P = 23.6%）。多因素分析显示，年龄在45至59岁（所有四种筛查情况P均<0.001）、初中、高中文化程度（所有四种筛查情况P均<0.001）及大学及以上文化程度（所有四种筛查情况P均<0.001）、配偶婚姻状况（所有四种筛查情况P均<0.001）、离婚状况（所有四种筛查情况P均<0.001）或丧偶状况（所有四种筛查情况P均<0.001）以及医疗保险状况（所有四种筛查情况P均<0.001）与四种筛查行为的比例呈正相关。
北京郊区居民“两癌”筛查行为水平仍有待提高，应持续对农村居民、45岁以下人群、未婚者、小学及以下文化程度者以及无医疗保险者开展精准营养与健康宣传及干预。
