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目的分析国家重大公共卫生服务项目育龄妇女乳腺癌、宫颈癌(以下简称两癌)筛查覆盖水平及影响因素。方法利用吉林省2013年卫生服务调查数据,共纳入15~64岁女性5 496人。计算育龄妇女两癌筛查覆盖率,并采用logistic回归对两癌筛查率的影响因素进行多因素分析。结果 2013年吉林省宫颈癌和乳腺癌筛查率仅为11.9%和14.7%,其中城市筛查率为15.13%和18.81%高于农村筛查率7.47%和9.09%。25~54岁年龄段两癌筛查率最高,宫颈癌和乳腺癌筛查率分别为16.27%和19.38%。多因素分析结果显示,中专以上学历、在校学生、婚姻状况和收入为两癌筛查的影响因素(P<0.05)。距离最近医疗机构距离、自评健康得分、5年内分娩与两癌筛查覆盖率均不相关(P>0.05)。结论吉林省两癌筛查利用水平较低,城乡差异较大。促进两癌筛查全面覆盖,应关注加强医保与公共卫生的整合衔接,健全各级医疗机构协作机制,并提供有效的健康教育。
Objective To analyze the screening coverage and influencing factors of breast cancer and cervical cancer (hereinafter referred to as two cancers) among the women of childbearing age in major national public health service projects. Methods Based on the 2013 health service survey data of Jilin Province, a total of 5 496 women aged 15-64 years were enrolled. The coverage rate of two cancer screening in women of childbearing age was calculated, and multivariate analysis was made on the influencing factors of screening rate of two cancers by logistic regression. Results The screening rates of cervical cancer and breast cancer in Jilin Province were only 11.9% and 14.7% in 2013, of which the urban screening rates were 15.13% and 18.81%, respectively, higher than the rural screening rates of 7.47% and 9.09%. The highest screening rates of both cancers were found in 25- to 54-year-olds, and the screening rates of cervical cancer and breast cancer were 16.27% and 19.38% respectively. Multivariate analysis showed that secondary school education, school-age students, marital status and income were the two risk factors for screening for cancer (P <0.05). Distance from the nearest medical institutions, self-rated health scores, childbirth within 5 years and two cancer screening coverage were not related (P> 0.05). Conclusion The levels of screening and utilization of two cancers in Jilin Province are relatively low, with large differences between urban and rural areas. To promote the comprehensive coverage of cancer screening, attention should be paid to strengthening the integration of health insurance and public health, improving the coordination mechanism of medical institutions at all levels and providing effective health education.