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越南宫颈癌筛查实践中的社会经济不平等:分解分析

Socioeconomic inequalities in cervical cancer screening practices in Vietnam: a decomposition analysis.

作者信息

Nguyen Thi Bich-Van, Vu Kim-Duy, Cu Lam Tung Ngoc, Ngoc Minh Hai Nguyen, Ho Hoang-Dung

机构信息

Department of Obstetrics and Gynaecology, Hanoi Medical University, Hanoi, Vietnam.

National Hospital of Obstetrics and Gynaecology, Hanoi, Vietnam.

出版信息

BMC Public Health. 2025 Apr 3;25(1):1253. doi: 10.1186/s12889-025-22511-y.

Abstract

BACKGROUND

In Vietnam, cervical cancer remains a critical public health issue, with disparities in screening uptake reflecting broader socioeconomic inequalities.

OBJECTIVE

This study aims to dissect socioeconomic disparities in cervical cancer screening uptake among Vietnamese women, using data from the 2020-2021 Multiple Indicator Cluster Survey 6 (MICS).

METHODS

Employing a cross-sectional design, we analysed MICS Survey data for women's cervical cancer screening reports over the past three years. The study utilised decomposition analysis to unravel the contributions of various determinants to socioeconomic disparities in screening uptake, employing Poisson regression with robust variance models to explore the association between socioeconomic status, quantified through Wealth Index quintiles, and screening practices.

RESULTS

Among participants, 28.2% reported receiving cervical cancer screening. The positive Erreygers concentration index value (ECI) was overall 0.296, which was statistically significant at a 1% level, indicating that cervical cancer screening was predominantly concentrated among individuals with higher wealth index scores. Decomposition analysis indicated that ethnic minority status significantly contributed to this disparity, alongside factors such as education and residency.

CONCLUSION

The use of the concentration index in this study elucidates significant socioeconomic and ethnic inequalities in cervical cancer screening in Vietnam. It underlines the necessity of tailored interventions aimed at the most disadvantaged groups, including ethnic minorities and low-income populations, to mitigate these disparities. Strategic policy reforms and targeted health initiatives are essential for promoting equitable access to cervical cancer screening and improving public health outcomes across Vietnam.

摘要

背景

在越南,宫颈癌仍然是一个关键的公共卫生问题,筛查接受率的差异反映了更广泛的社会经济不平等。

目的

本研究旨在利用2020 - 2021年多指标类集调查6(MICS)的数据,剖析越南女性宫颈癌筛查接受率中的社会经济差异。

方法

采用横断面设计,我们分析了过去三年MICS调查中女性宫颈癌筛查报告的数据。该研究利用分解分析来揭示各种决定因素对筛查接受率社会经济差异的贡献,采用稳健方差模型的泊松回归来探索通过财富指数五分位数量化的社会经济地位与筛查行为之间的关联。

结果

在参与者中,28.2%报告接受了宫颈癌筛查。整体的埃雷格斯集中指数(ECI)正值为0.296,在1%水平上具有统计学意义,表明宫颈癌筛查主要集中在财富指数得分较高的个体中。分解分析表明,少数民族身份以及教育和居住等因素对这种差异有显著贡献。

结论

本研究中集中指数的使用揭示了越南宫颈癌筛查中显著的社会经济和种族不平等。它强调了针对最弱势群体,包括少数民族和低收入人群,采取针对性干预措施以减轻这些差异的必要性。战略政策改革和有针对性的健康倡议对于促进越南公平获得宫颈癌筛查和改善公共卫生结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab66/11966878/451f87e794aa/12889_2025_22511_Fig1_HTML.jpg

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