Sun Qian, Hu Junguo, Ye Yancheng, Ma Li, Zhang Xiaoqian, Yang Rui, Huang Yue
Gansu Wuwei Academy of Medical Sciences, Gansu Wuwei Tumor Hospital, Gansu, China.
BMC Cancer. 2025 Jul 28;25(1):1225. doi: 10.1186/s12885-025-14586-y.
Based on Anderson model theory, a pathway analysis model of breast cancer screening population in this region was constructed to explore the impact of smoking on breast cancer screening results, in order to provide reference for refining breast cancer screening strategies and programs.
Firstly, the distribution of each variable in terms of whether breast related diseases were detected was described by single factor analysis. Then, based on the results of factor screening, a screening outcome pathway analysis model for female breast cancer screening population in 2021-2023 was constructed to determine the influence path and influence coefficient of smoking on breast cancer screening results.
A total of 1,792 female residents participated in breast cancer screening between 2021 and 2023, and 353 were detected with breast related disease, a detection rate of 19.7%. The result of path analysis model shows that the overall model fits well (RMSEA<0.001、CFI = 1.000、TLI = 1.001、SRMR = 0.024). The most significant variable of propensity characteristic dimension is the highest education (t=-2.135,P = 0.033); The significant variable in the dimension of medical behavior was smoking (t = 2.504,P = 0.012). The path coefficient indicates that the female population with lower education and smoking is more likely to detect mamma-related lesions in the screening population. In addition to the direct effect of smoking on the detection of mast-related lesions (effect size - 0.105), smoking also acted as a mediating variable to mediate the indirect effect of the highest education on the detection of mast-related lesions (effect size - 0.016).
The results of this study confirmed the impact of smoking on breast cancer screening results, suggesting that health workers should further strengthen the publicity and education of residents on smoking cessation, optimize local screening strategies, and strengthen local residents' awareness of primary cancer prevention.
基于安德森模型理论，构建本地区乳腺癌筛查人群的路径分析模型，探讨吸烟对乳腺癌筛查结果的影响，为优化乳腺癌筛查策略及方案提供参考。
首先，通过单因素分析描述各变量在是否检出乳腺相关疾病方面的分布情况。然后，基于因子筛选结果，构建2021 - 2023年女性乳腺癌筛查人群的筛查结果路径分析模型，以确定吸烟对乳腺癌筛查结果的影响路径及影响系数。
2021年至2023年共有1792名女性居民参与乳腺癌筛查，其中353人检出乳腺相关疾病，检出率为19.7%。路径分析模型结果显示，整体模型拟合良好（RMSEA<0.001、CFI = 1.000、TLI = 1.001、SRMR = 0.024）。倾向特征维度中最显著的变量是最高学历（t = -2.135，P = 0.033）；医疗行为维度中的显著变量是吸烟（t = 2.504，P = 0.012）。路径系数表明，在筛查人群中，学历较低且吸烟的女性人群更易检出乳腺相关病变。吸烟除了对乳腺相关病变检出有直接效应（效应大小 -0.105）外，还作为中介变量介导了最高学历对乳腺相关病变检出的间接效应（效应大小 -0.016）。
本研究结果证实了吸烟对乳腺癌筛查结果的影响，提示卫生工作者应进一步加强对居民戒烟的宣传教育，优化当地筛查策略，增强当地居民的原发性癌症预防意识。
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