Rustamadji Primariadewi, Sartika Ratu Ayu Dewi, Lubis Pika Novriani, Purwanto Edy, Ishak Ismarulyusda, Istamayu Amalia Ane, Wiyarta Elvan
Department of Anatomic Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia.
Department of Public Health Nutrition, Faculty of Public Health, Universitas Indonesia, Depok 16424, Indonesia.
J Clin Med. 2025 Apr 15;14(8):2699. doi: 10.3390/jcm14082699.
Breast cancer is the predominant cause of cancer in developing nations, and screening through breast self-examinations and mammograms is crucial in mitigating morbidity and mortality. Nonetheless, geographic disparities in screening methods persist, attributable to sociodemographic variation and healthcare accessibility. This study aimed to analyze the influence of women's screening practices for breast cancer and other risks, stratified by urban and rural areas in Indonesia. A case-control design was adopted, including all women who had breast cancer in 2014 as the study subjects. The Indonesian Family Life Survey data from 2007, with subjects aged at least 15 years, and from 2014 were used. Unconditional logistic regression was used to analyze the risk factors of breast cancer. After controlling for confounders, the odds of breast cancer diagnosis were higher in women who performed breast self-examination (BSE) (aOR 10.22; 95% CI 1.04-50.81 and aOR 11.10; 95% CI 3.32-37.08) and those married before the age of 19 (aOR 4.81; 95% CI 1.93-6.05 and aOR 5.35; 95% CI 1.49-19.7), in urban and rural areas, respectively. In addition, women who had undergone mammography (aOR 48.04; 95% CI 10.33-83.45) had significantly higher odds of being diagnosed with breast cancer in urban areas. In rural areas, a paternal history of cancer-related death had higher odds of breast cancer (aOR 30.63; 95% CI 6.04-60.41) than those without a parental history of cancer. This study highlights the importance of intensifying national breast cancer screening, including BSE campaigns and expanding mammography infrastructure, particularly in rural areas, for improving breast cancer prevention and early diagnosis.
乳腺癌是发展中国家癌症的主要病因，通过乳房自我检查和乳房X光检查进行筛查对于降低发病率和死亡率至关重要。尽管如此，由于社会人口差异和医疗可及性，筛查方法的地域差异仍然存在。本研究旨在分析印度尼西亚城乡地区女性乳腺癌及其他风险筛查行为的影响。采用病例对照设计，将2014年所有患乳腺癌的女性作为研究对象。使用了2007年和2014年印度尼西亚家庭生活调查数据，调查对象年龄至少为15岁。采用无条件逻辑回归分析乳腺癌的危险因素。在控制混杂因素后，进行乳房自我检查（BSE）的女性患乳腺癌诊断的几率更高（城市地区调整后比值比[aOR]为10.22；95%置信区间[CI]为1.04 - 50.81，农村地区aOR为11.10；95% CI为3.32 - 37.08），以及19岁前结婚的女性（城市地区aOR为4.81；95% CI为1.93 - 6.05，农村地区aOR为5.35；95% CI为1.49 - 19.7）。此外，在城市地区，接受过乳房X光检查的女性（aOR为48.04；95% CI为10.33 - 83.45）被诊断为乳腺癌的几率显著更高。在农村地区，有癌症相关死亡家族史的父亲患乳腺癌的几率（aOR为30.63；95% CI为6.04 - 60.41）高于没有癌症家族史的人。本研究强调了加强全国乳腺癌筛查的重要性，包括开展乳房自我检查宣传活动和扩大乳房X光检查基础设施，特别是在农村地区，以改善乳腺癌预防和早期诊断。
