Gao Di, Wang Xueyin, Juan Juan, Pei Zhifei, Zhang Xiaosong
Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, 100034, China.
Department of Obstetrics and Gynecology, Xicheng Maternal and Child Health Care Hospital, Beijing, 100054, China.
BMC Public Health. 2025 May 17;25(1):1821. doi: 10.1186/s12889-025-22971-2.
Cervical cancer is regarded as the fourth most common cancer in terms of both incidence and mortality among women worldwide. Cervical cancer screening is a crucial method to achieve early diagnosis and treatment of cervical intraepithelial neoplasia and cervical cancer. The screening behaviors among women have been linked to knowledge level of cervical cancer prevention, yet little is known about the association in various areas and regions of China.
A cross-sectional study was conducted from June to September 2018 in six provinces of China. In this survey, knowledge level of cervical cancer prevention was assessed by a set of 7 question items, including the awareness, risk factors, preventive actions of cervical cancer, as well as awareness and effects of HPV vaccines, and also the benefits of regular cervical cancer screening. Screening behavior was determined by asking women whether they have had ever participated in cervical cancer screening. Socio-demographic characteristics were collected by questionnaire. Multivariate logistic regression models were used to analyze the association between cervical cancer screening behaviors and knowledge level.
A total of 9144 women aged 20-49 years were involved in the analysis, with an average age of 37.9 ± 8.5 years. There were 37.6% of participants reported having ever screened for cervical cancer. The rate of cervical cancer screening behaviors was significantly associated with region, area, age group, occupation, education level, marital status, gravidity and knowledge level. Women with a high level of knowledge (score ≥ 5) were more likely to have screening behaviors than those with a low knowledge level (OR = 2.91, 95% CI: 2.63-3.21). Compared to women in the knowledge score ≤ 1 group, the screening rate of women with the knowledge score ≥ 6 significantly increased regardless of the regions (western region: OR = 19.62, 95% CI: 12.39-31.04; central region: OR = 10.09, 95% CI: 6.76-15.06; eastern region: OR = 5.23, 95%CI: 3.62-7.56) and areas (urban area: OR = 12.70, 95% CI: 8.79-18.36; rural area: OR = 7.12, 95%CI: 5.19-9.77).
Overall, our study demonstrated that the screening rate and knowledge level of cervical cancer among Chinese women still need to be improved. There was a significant association between knowledge scores and screening rates, regardless of region or area. Therefore, it is necessary to enhance the knowledge level of cervical cancer through intervention measures in order to promote regular cervical cancer screening.
宫颈癌在全球女性中的发病率和死亡率均位居第四。宫颈癌筛查是实现宫颈上皮内瘤变和宫颈癌早期诊断与治疗的关键方法。女性的筛查行为与宫颈癌预防知识水平相关，但中国不同地区的这种关联尚不清楚。
2018年6月至9月在中国六个省份进行了一项横断面研究。在本次调查中，通过一组7个问题项评估宫颈癌预防知识水平，包括宫颈癌的知晓情况、危险因素、预防措施，以及HPV疫苗的知晓情况和效果，还有定期宫颈癌筛查的益处。通过询问女性是否曾参加过宫颈癌筛查来确定筛查行为。通过问卷调查收集社会人口学特征。使用多因素逻辑回归模型分析宫颈癌筛查行为与知识水平之间的关联。
共有9144名年龄在20 - 49岁的女性参与分析，平均年龄为37.9±8.5岁。37.6%的参与者报告曾进行过宫颈癌筛查。宫颈癌筛查行为的发生率与地区、区域、年龄组、职业、教育水平、婚姻状况、妊娠情况和知识水平显著相关。知识水平高（得分≥5）的女性比知识水平低的女性更有可能进行筛查行为（OR = 2.91，95%CI：2.63 - 3.21）。与知识得分≤1组的女性相比，无论在哪个地区（西部地区：OR = 19.62，95%CI：12.39 - 31.04；中部地区：OR = 10.09，95%CI：6.76 - 15.06；东部地区：OR = 5.23，95%CI：3.62 - 7.56）和区域（城市地区：OR = 12.70，95%CI：8.79 - 18.36；农村地区：OR = 7.12，95%CI：5.19 - 9.77），知识得分≥6的女性筛查率均显著提高。
总体而言，我们的研究表明中国女性宫颈癌的筛查率和知识水平仍有待提高。无论地区或区域如何，知识得分与筛查率之间均存在显著关联。因此，有必要通过干预措施提高宫颈癌知识水平，以促进定期宫颈癌筛查。
