凉山州5个地区对宫颈癌高危因素认知差异影响因素的分析

Analysis of influencing factors of cognition difference in cervical cancer high-risk factors among five regions in Liangshan prefecture

目的 寻找凉山州5个地区妇女宫颈癌发病的高危因素差异,探讨降低宫颈癌的有效措施.方法 对凉山州5个地区县城及各乡镇周边村的成年妇女进行问卷调查,调查内容包括一般资料、既往病史、性行为和生育史、对宫颈癌筛查的知晓情况及参与情况等方面.结果 凉山州5个地区因存在民族、教育、生活环境、经济收入的不同,造成宫颈癌发病高危因素的差异.教育情况好的地区认知情况明显好于教育情况差的地区,有统计学差异（χ2 =16.11,P〈0.05）,认知情况由高到低依次为西昌、会理、冕宁、金阳、普格.汉族妇女的收入、教育、生活环境明显好于彝族妇女,且存在城镇、农村的差别;汉族之间、彝族之间不同生活环境的妇女对宫颈癌筛查目的 的认知亦存在差异,有统计学意义（χ2=27.85,P〈0.05）.上述原因影响5个地区妇女对宫颈癌易患因素（χ2=36.77）、需要治疗的宫颈病变的了解（χ2=49.03）及参与宫颈癌筛查（细胞学涂片检查：χ2=60.93,常规妇检：χ2=66.40）的情况,均存在统计学差异（均P〈0.05）.结论 5个地区间宫颈癌发病高危因素存在差异,从而引起不同发病率,提高对宫颈癌高危因素的认识,提高妇女自身素质,加大宫颈癌筛查力度及范围,控制高危因素则可降低地区间的差异.

Objective To explore the differences in high-risk factors of cervical cancer in five regions of Liangshan Prefecture and investigate effective measures to reduce cervical cancer. Methods Adult women in counties and villages of Liangshan prefecture were investigated with questionnaires, including general information, past medical history, sexual behavior and reproductive history, the awareness of cervical cancer screening and participation and so on. Results There were differences in nation, education, living environment and income among five regions, which caused the differences in high-risk factors of cervical cancer. The cognition of women in regions where education was better was better than that of those in regions with worse education, and the difference was statistically significant （χ2= 16.11 ,P 〈 0.05 ）. The cognition was best in Xichang, followed by Huili, Mianning, Jinyang and Puge in turn. The income, education and living environment of women of Han nationality were significantly better than those of women of Yi nationality, and there was difference between towns and villages. There was also difference in cognition on cervical cancer screening among women with different living environment both in Han nationality and Yi nationality, and the difference was significant （χ2 = 27.85 ,P 〈 0.05 ）. All of the above factors influenced the understanding of women in these five regions in susceptible factors of cervical cancer （χ2 = 36.77 ） and in cervical lesions needing cure, and affected their participating in cervical cancer screening （smear checking： χ2 = 60.93, conventional gynecological examination： χ2 =66.40）. The differences were significant （all P 〈0.05）. Conclusion The high-risk factors of cervical cancer among five regions are different, which leads to different incidence of cervical cancer. Improving the cognition on high-risk factors of cervical cancer, improving women＇ s quality, strengthening cervical cancer screening and controlling high-risk factors can reduce the difference among different regions.