Liao Janny, Moshoeshoe Ramaele, Holmes Michelle D, Subramanian S V, De Neve Jan-Walter
Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, University of Heidelberg, Heidelberg, Germany.
Harvard College, Harvard University, Cambridge, MA, USA.
Nat Commun. 2025 Apr 20;16(1):3737. doi: 10.1038/s41467-025-58875-3.
Breast and cervical cancers are important causes of disability and premature death among women in Sub-Saharan Africa. Previous research has linked girls' education to cancer service access. Here, we examine the causal effect of girls' educational attainment on cancer screening practices by means of a natural experiment in Lesotho. In particular, we exploit variation in educational attainment among women that was introduced by an educational policy (a school-entry age cut-off). Data on awareness towards breast cancer, knowledge of Pap smear, breast self-exam, breast clinical exam, and having received a Pap smear is extracted from the Lesotho Demographic and Health Surveys 2009-10 and 2014 (N = 7971). Each additional year of schooling caused by the education policy increases awareness of breast cancer by 4.7 percentage points (p = 0.014, 95% Confidence Interval [CI]: 1.0, 8.5), awareness of Pap smear by 5.9 percentage points (p = 0.001, 95% CI: 2.3, 9.5), and engagement in Pap smear by 3.5 percentage points (p = 0.004, 95% CI: 1.1, 5.8). We found no statistically significant effects on breast self-exam and breast clinical exam.
乳腺癌和宫颈癌是撒哈拉以南非洲地区女性致残和过早死亡的重要原因。先前的研究已将女孩教育与癌症服务可及性联系起来。在此，我们通过莱索托的一项自然实验，研究女孩教育程度对癌症筛查行为的因果效应。具体而言，我们利用一项教育政策（入学年龄截止线）所带来的女性教育程度差异。关于乳腺癌认知、巴氏涂片检查知识、乳房自我检查、乳房临床检查以及是否接受过巴氏涂片检查的数据，取自2009 - 2010年和2014年的莱索托人口与健康调查（N = 7971）。由该教育政策导致的每多接受一年教育，会使乳腺癌认知提高4.7个百分点（p = 0.014，95%置信区间[CI]：1.0，8.5），巴氏涂片检查认知提高5.9个百分点（p = 0.001，95% CI：2.3，9.5），以及巴氏涂片检查参与率提高3.5个百分点（p = 0.004，95% CI：1.1，5.8）。我们未发现对乳房自我检查和乳房临床检查有统计学上的显著影响。
Zotero 插件