高发区农村妇女子宫颈癌现患率及筛查意愿分析

Analysis on the prevalence rate of cervical cancer and screening willingness of rural women from the areas with high prevalence of cervical cancer

目的:通过农村妇女子宫颈癌及癌前病变的筛查和子宫颈癌筛查意愿的分析,了解我国农村妇女子宫颈癌现患率及其筛查的认知情况和接受筛查的意愿现状。方法:采用整群抽样的方法,选取我国农村子宫颈癌高发区山西省襄垣县、江西省靖安县现场30～59岁的妇女,进行子宫颈癌筛查及对子宫颈癌认知、筛查意愿的调查。初筛方案采用子宫颈肉眼观察(VIA/VILI),以组织病理学检查为依据进行病变的诊断及转归的判定。通过面对面的问卷调查,采用统一设计的调查表,由经过严格培训的调查员收集信息。采用Visual FoxPro进行数据录入和管理,SPSS 13.0对数据进行统计分析。结果:山西省襄垣县及江西省靖安县现场分别有5 610例及5 266例完成筛查。查出宫颈上皮内瘤样病变Ⅱ级及以上(CINⅡ+)病例为84例和19例,检出率分别为1.50%和0.36%。对各年龄组CINⅡ+的检出率进行分析,结果发现江西省靖安县的检出率以30～34岁和55～59岁两个年龄组较高;而山西省襄垣县检出率最高的是50～54岁年龄组,45～49岁年龄组和35～39岁年龄组其次。随着文化程度的增加,妇女对于子宫颈癌认知率也随之增加(P<0.05)。两个现场的研究对象对筛查必要性的认识及子宫颈癌筛查费用的支付意愿均较高(98.43%、85.81%);但支付能力却较低,都在30元以下。结论:①在农村高发区开展子宫颈癌筛查可以有效降低妇女CINⅡ+现患率,提高子宫颈癌早诊率和早治率。②农村妇女的受教育程度影响子宫颈癌及其筛查目的认知水平。③高发区农村妇女对子宫颈癌及其筛查必要性的认知水平及支付意愿都较高,但支付能力却相对不足。

Objective：To understand the prevalence rate of cervical cancer,the awareness degree of screening,and current situation of willingness of receiving screening in rural women in China by cervical cancer and cervical precancerous lesions screening and analyzing screening willingness of cervical cancer.Methods：Cluster sampling method was used to select 30-59-year-old rural women from Xiangyuan county of Shanxi province and Jing＇an county of Jiangxi province which were areas with high prevalence of cervical cancer,an investigation about cervical cancer screening,awareness of cervical cancer,and screening willingness were performed.The primary screening program was cervical visual observation（acetic acid test and iodine test）,diagnosis and determination of prognosis were obtained according to results of histopathological examination.The informations were collected by investigators after strict training by face-to-face questionnaire investigation and a uniform questionnaire.Visual FoxPro software was used for data entry and data management,SPSS 13.0 software was used to analyze data statistically.Results：A total of 5 610 women in Xiangyuan county of Shanxi province and a total of 5 266 women in Jing＇an county of Jiangxi province were screened,84 women with cervical intraepithelial neoplasia（CIN） Ⅱ and 19 women with CIN Ⅱ above lesions were screened out,the detection rates were 1.50% and 0.36%,respectively.The detection rates of CIN Ⅱ above lesions in 30-34-year-old women and 55-59-year-old women from Jing＇an county of Jiangxi province were the highest;while in Xiangyuan county of Shanxi province,the detection rate in 50-54-year-old women was the highest,followed by 45-49-year-old women and 35-39-year-old women.The awareness rate of women to cervical cancer increased significantly with educational level（P0.05）.The cognition of the study objects from the two counties to screening and their willingness of paying fee for cervical cancer screening were relatively high,which were 98.43% and 85.81%,respectively;but the ability to pay fee was relatively low,the mean level was less than 30 Yuan.Conclusion：Conducting cervical cancer screening in rural areas with high prevalence of cervical cancer can effectively reduce prevalence rate of CIN Ⅱ above lesions and improve the rates of early diagnosis and early treatment of cervical caner.The educational level of rural women has impact on cognitive levels of cervical cancer and screening aim.The cognitive levels of cervical cancer and screening necessity and willingness of paying fee for cervical cancer screening in rural women from areas with high prevalence of cervical cancer are relatively high,but their paying ability is low.