Kawuki Joseph, Savi Victor, Betunga Benjamin, Gopang Meroona, Isangula Kahabi Ganka, Nuwabaine Lilian
Department of Family, Population, & Preventive Medicine, Stony Brook University, New York, USA.
Health and Welfare Department, Satakunta University of Applied Sciences, Pori, Finland.
Soc Sci Med. 2025 Feb;367:117722. doi: 10.1016/j.socscimed.2025.117722. Epub 2025 Jan 20.
Promoting regular screening remains one of the primary preventive measures for breast and cervical cancer. The study aimed to assess the prevalence and barriers to breast and cervical cancer screening among adolescent girls and young women (AGYW) in Kenya. The study used data from the 2022 Kenya Demographic and Health Survey (KDHS), with 12,026 AGYW who were selected by multistage sampling. The outcomes of interest were breast and cervical cancer screening. Multivariable logistic regression was used to assess factors negatively associated with the outcome variables, using SPSS (version 29.0). Of the 12,026 AGYW included in this study, only 6.0% (95%CI: 5.6-6.8) and 5.1% (95%CI: 4.8-6.0) had undertaken breast and cervical cancer screening, respectively. Low education (AOR = 0.08, 95%CI: 0.02-0.34 and AOR = 0.48, 95%CI: 0.28-0.83), not working (AOR = 0.67, 95%CI: 0.46-0.97 and AOR = 0.59, 95%CI: 0.42-0.82), low wealth index (AOR = 0.55, 95%CI: 0.32-0.92 and AOR = 0.45, 95%CI: 0.25-0.81), no visit to a healthcare facility in the last 6 months (AOR = 0.48, 95%CI: 0.33-0.69 and AOR = 0.50, 95%CI: 0.35-0.71), and no birth record (AOR = 0.29, 95%CI: 0.13-0.62 and AOR = 0.58, 95%CI: 0.27-0.74), were the major barriers to both breast and cervical cancer screening, respectively. Moreover, having no access to newspaper (AOR = 0.67, 95%CI: 0.46-0.97) was a significant barrier to breast cancer screening while having big problems with distance to a healthcare facility (AOR = 0.49, 95%CI: 0.33-0.73) and not using modern contraception (AOR = 0.60, 95%CI: 0.42-0.86) hindered cervical cancer screening. In conclusion, more efforts are needed from both the government and cancer stakeholders to increase accessibility of breast and cervical cancer screening services, especially to those with low social economic status. More targeted education and sensitization, improving livelihoods of AGYW through various women empowerment efforts, and improving screening capacity of low-grade healthcare facilities are among the useful strategies to improve the low screening rates.
推广定期筛查仍然是乳腺癌和宫颈癌的主要预防措施之一。该研究旨在评估肯尼亚青春期女孩和年轻女性（AGYW）中乳腺癌和宫颈癌筛查的普及率及障碍因素。该研究使用了2022年肯尼亚人口与健康调查（KDHS）的数据，通过多阶段抽样选取了12,026名AGYW。感兴趣的结果是乳腺癌和宫颈癌筛查。使用SPSS（版本29.0）进行多变量逻辑回归，以评估与结果变量呈负相关的因素。在本研究纳入的12,026名AGYW中，分别只有6.0%（95%置信区间：5.6 - 6.8）和5.1%（95%置信区间：4.8 - 6.0）进行过乳腺癌和宫颈癌筛查。低教育程度（调整后比值比[AOR]=0.08，95%置信区间：0.02 - 0.34以及AOR = 0.48，95%置信区间：0.28 - 0.83）、未就业（AOR = 0.67，95%置信区间：0.46 - 0.97以及AOR = 0.59，95%置信区间：0.42 - 0.82）、低财富指数（AOR = 0.55，95%置信区间：0.32 - 至0.92以及AOR = 0.45，95%置信区间：0.25 - 0.81）、过去6个月未去过医疗机构（AOR = 0.48，95%置信区间：0.33 - 0.69以及AOR = 0.50，95%置信区间：0.35 - 0.71）以及没有出生记录（AOR = 0.29，95%置信区间：0.13 - 0.62以及AOR = 0.58，95%置信区间：0.27 - 0.74），分别是乳腺癌和宫颈癌筛查的主要障碍。此外，无法获取报纸（AOR = 0.67，95%置信区间：0.46 - 0.97）是乳腺癌筛查的一个重要障碍，而到医疗机构的距离存在较大问题（AOR = 0.49，95%置信区间：0.33 - 0.73）以及未使用现代避孕方法（AOR = 0.60，95%置信区间：0.42 - 0.86）阻碍了宫颈癌筛查。总之，政府和癌症相关利益方需要做出更多努力来提高乳腺癌和宫颈癌筛查服务的可及性，特别是针对社会经济地位较低者。更有针对性的教育和宣传、通过各种妇女赋权努力改善AGYW的生计以及提高基层医疗机构的筛查能力，都是提高低筛查率的有效策略。
