Olivieri Daniel J, Eastment McKenna C, Mugisha Noleb, Menon Manoj P
Department of Medicine, Internal Medicine Residency Program, University of Washington, Seattle, Washington, United States of America.
Division of Allergy and Infectious Disease, Department of Medicine, Seattle, Washington, United States of America.
PLOS Glob Public Health. 2025 May 7;5(5):e0003344. doi: 10.1371/journal.pgph.0003344. eCollection 2025.
Cervical cancer is the leading cause of cancer-related mortality in low- and middle-income countries (LMICs). Prior studies associate high cervical cancer awareness with reductions in cervical cancer incidence. In this study, we utilize nationally representative Demographic and Health Surveys Program (DHS) to analyze correlates of cervical cancer awareness to inform global strategies. All DHS surveys between 2017-2023 were queried for questions on cervical cancer awareness. Socio-demographic variables (e.g., age, marital status), socioeconomic variables (e.g., education, wealth, literacy) and variables pertaining to healthcare decision making, distance traveled, intimate partner violence (IPV), and female genital mutilation/circumcision (FGC/M)) were extracted. Sample weights were applied, and logistic regressions were performed. Variables with p < 0.20 were included in multivariate analysis. Data was obtained from 30,214 women aged 30-49 years old living in Benin, Cameroon, Madagascar, Mauritania, and Mozambique, 19,403 of whom were asked questions on cervical cancer awareness. Cervical cancer awareness varied from 53% in Cameroon to 12% in Benin. Literacy, frequency of watching television, mobile telephone ownership, visiting a local healthcare facility and hormonal contraceptive use were associated with increased cervical cancer awareness, while lack of healthcare decision making independence was associated with decreased awareness after multivariate adjustment. Women who experienced emotional IPV were associated with increased awareness in Cameroon. Less than 4% of all women were screened for cervical cancer. Given the known association between awareness and screening, targeted efforts to increase awareness among women without communication modalities has the potential to reduce global cervical cancer disparities. Potential strategies include co-locating cervical cancer awareness programs with public health programs and implementing large-scale telecommunication outreach programs to improve awareness.
宫颈癌是低收入和中等收入国家（LMICs）癌症相关死亡的主要原因。先前的研究表明，高宫颈癌知晓率与宫颈癌发病率的降低有关。在本研究中，我们利用具有全国代表性的人口与健康调查项目（DHS）来分析宫颈癌知晓率的相关因素，以为全球战略提供信息。查询了2017年至2023年期间所有DHS调查中有关宫颈癌知晓率的问题。提取了社会人口统计学变量（如年龄、婚姻状况）、社会经济变量（如教育程度、财富、识字率）以及与医疗保健决策、出行距离、亲密伴侣暴力（IPV）和女性生殖器切割/环切（FGC/M）相关的变量。应用了样本权重，并进行了逻辑回归分析。p值<0.20的变量纳入多变量分析。数据来自居住在贝宁、喀麦隆、马达加斯加、毛里塔尼亚和莫桑比克的30214名30至49岁的女性，其中19403人被问及有关宫颈癌知晓率的问题。宫颈癌知晓率从喀麦隆的53%到贝宁的12%不等。识字率、看电视频率、拥有移动电话、前往当地医疗机构就诊以及使用激素避孕药与宫颈癌知晓率的提高相关，而缺乏医疗保健决策独立性在多变量调整后与知晓率降低相关。在喀麦隆，经历过情感暴力的女性与知晓率提高相关。所有女性中接受宫颈癌筛查的不到4%。鉴于已知知晓率与筛查之间的关联，有针对性地努力提高没有沟通方式的女性的知晓率有可能减少全球宫颈癌差异。潜在策略包括将宫颈癌知晓项目与公共卫生项目设在同一地点，并实施大规模电信外展项目以提高知晓率。
