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孟加拉国成年人对宫颈癌及其社会经济决定因素的认知:一项全国性横断面研究的结果

Awareness about cervical cancer and its socio-economic determinants among adults in Bangladesh: Results from a nationwide cross-sectional study.

作者信息

Islam Tariful, Khan Md Abdullah Saeed, Hawlader Mohammad Delwer Hossain, Meem Nur-E-Safa, Eva Fahima Nasrin, Monisha Umme Kulsum, Hossain Mohammad Ali, Nabi Mohammad Hayatun

机构信息

Department of Public Health, North South University, Dhaka, Bangladesh.

Public Health Promotion and Development Society (PPDS), Dhaka, Bangladesh.

出版信息

PLoS One. 2025 Jun 10;20(6):e0325712. doi: 10.1371/journal.pone.0325712. eCollection 2025.

DOI:10.1371/journal.pone.0325712
PMID:40493576
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12151404/
Abstract

Cervical cancer is a major global health issue now and is the second leading cancer among women in Bangladesh, caused primarily by Human papillomavirus (HPV). Despite effective vaccination and screening methods, awareness and access to preventive methods are limited in developing regions. This nationwide study aims to explore socio-economic and cultural factors affecting cervical cancer awareness in Bangladesh and generate evidence-based recommendations for tailoring suitable health promotion strategies for the country. This cross-sectional study was conducted in Bangladesh to evaluate cervical cancer awareness among adults aged 18 years and above. A semi-structured questionnaire was designed for this research, keeping in mind the local sociocultural contexts. Face-to-face interviews were conducted after getting the participants' consent and making sure they understood all the questions. After checking for data quality and consistency, responses of 2,151 participants were finally retained. The collected data was analyzed using STATA (Version 17) statistical software. The majority (80.15%) of the participants were aware of cervical cancer, with healthcare workers being the primary source of information. Higher awareness rates were noted among married individuals (80.88%), urban dwellers (83.24%), those with more education (average 11.96 ± 4.36 years), individuals with higher income (88.17%), and those belonging to nuclear families (82.86%). Healthcare professionals had significantly greater awareness (98.91%) compared to other occupations. Participants undergoing regular health checkups were more informed and the association was statistically significant (87.03%, p < 0.001). Univariate and multiple logistic regression models revealed that each additional year of education increased the probability of being aware by 16-20%. Men had significantly lower odds of being aware compared to women (Adjusted Odds Ratio AOR = 0.41, β = -0.895, 95% CI: 0.23 to 0.70, p = 0.001 in the multiple logistic regression analysis). Similarly, respondents not cohabitating with their spouse were less aware than those who were living with partners (AOR = 0.47, β = -0.750, 95% CI: 0.28 to 0.81, p = 0.006). Income levels conversely influenced awareness level, participants from the highest income group (earning 35,001-50,000 BDT) had 47% lower odds (AOR = 0.53, β = -0.629, 95% CI: 0.36 to 0.80, p = 0.002) of awareness compared to the lowest income group (earning ≤20,000 BDT). Despite the widespread awareness of cervical cancer among most Bangladeshi adults, there remains a notable gap, particularly among certain demographics. Since the study identified healthcare workers, social media, and mass media as major sources of information, targeted educational campaigns through media channels and outreach activities by healthcare workers might effectively enhance nationwide awareness of cervical cancer.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e1d/12151404/5740340133d7/pone.0325712.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e1d/12151404/95b344a71900/pone.0325712.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e1d/12151404/5740340133d7/pone.0325712.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e1d/12151404/95b344a71900/pone.0325712.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e1d/12151404/5740340133d7/pone.0325712.g002.jpg
摘要

宫颈癌是目前全球主要的健康问题,在孟加拉国是女性第二大常见癌症,主要由人乳头瘤病毒(HPV)引起。尽管有有效的疫苗接种和筛查方法,但在发展中地区,人们对预防方法的认知和获取途径仍然有限。这项全国性研究旨在探讨影响孟加拉国宫颈癌认知的社会经济和文化因素,并为该国制定合适的健康促进策略提供循证建议。这项横断面研究在孟加拉国开展,以评估18岁及以上成年人对宫颈癌的认知情况。考虑到当地的社会文化背景,为此研究设计了一份半结构化问卷。在获得参与者同意并确保他们理解所有问题后,进行了面对面访谈。在检查数据质量和一致性后,最终保留了2151名参与者的回答。使用STATA(版本17)统计软件对收集的数据进行分析。大多数(80.15%)参与者知晓宫颈癌,医护人员是主要信息来源。已婚人士(80.88%)、城市居民(83.24%)、受教育程度较高者(平均11.96±4.36年)、收入较高者(88.17%)以及核心家庭的成员(82.86%)的知晓率较高。与其他职业相比,医护人员的知晓率显著更高(98.91%)。接受定期健康检查的参与者了解得更多,且这种关联具有统计学意义(87.03%,p<0.001)。单因素和多因素逻辑回归模型显示,每增加一年教育,知晓的概率增加16%-20%。与女性相比,男性知晓的几率显著更低(多因素逻辑回归分析中,调整后的优势比AOR=0.41,β=-0.895,95%置信区间:0.23至0.70,p=0.001)。同样,与配偶不同居的受访者比与伴侣同住的受访者知晓程度更低(AOR=0.47,β=-0.750,95%置信区间:0.28至0.81,p=0.006)。收入水平反过来影响知晓程度,最高收入组(收入35001-50000孟加拉塔卡)的参与者知晓的几率比最低收入组(收入≤20000孟加拉塔卡)低47%(AOR=0.53,β=-0.629,95%置信区间:0.36至0.80,p=0.002)。尽管大多数孟加拉国成年人对宫颈癌有广泛认知,但仍存在显著差距,特别是在某些特定人群中。由于该研究确定医护人员、社交媒体和大众媒体是主要信息来源,通过媒体渠道开展有针对性的教育活动以及医护人员开展外展活动可能会有效提高全国对宫颈癌的认知。

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