Life-course socioeconomic status and breast and cervical cancer screening: analysis of the WHO's Study on Global Ageing and Adult Health (SAGE).
Life-course socioeconomic status and breast and cervical cancer screening: analysis of the WHO's Study on Global Ageing and Adult Health (SAGE).
复制标题
DOI：
10.1136/bmjopen-2016-012753
复制
发表时间：
2016-11-22
期刊：
影响因子：
2.9
通讯作者：
Braithwaite, Dejana
中科院分区：
文献类型：
--
作者：
Akinyemiju, Tomi;Ogunsina, Kemi;Braithwaite, Dejana
目的：在高收入国家，筛查的社会经济差异已经有了很好的记录;然而，很少有研究在低收入和中等收入国家检查与癌症筛查有关的生命过程中的社会经济地位（SES）。在这里，我们研究个体，父母和生命历程SES的差异，在乳腺癌和宫颈癌筛查中的妇女在印度，中国，墨西哥，俄罗斯和南非。SETTING：数据从世界卫生组织的研究全球老龄化和成人健康（SAGE）2007-2008年的数据被用于调查加权多变量回归分析。我们使用基于教育和基于就业的SES测量方法，研究了个体、父母和生命历程SES与乳腺癌和宫颈癌筛查之间的关联。参与者： 22283名年龄在18-65岁的女性 ，来自中国、印度、墨西哥、俄罗斯和南非。（OR 4.18; 95%CI 2.36至7.40）与未接受正规教育相比，增加了乳腺癌筛查的几率。与父母SES低的女性相比，父母SES高的女性接受乳腺癌筛查的可能性几乎高出10倍（OR 9.84; 95%CI 1.75至55.5）。稳定的较高寿命（OR 3.07; 95% CI 1.96 - 4.79）乳腺癌筛查增加3倍，宫颈癌筛查增加4倍以上（OR 4.35; 95% CI 2.94 - 6.45）;然而，生命周期SES下降与乳腺癌筛查减少相关（OR 0.26; 95%CI 0.08至0.79）相比，低的生命历程SES.CONCLUSIONS：较高的个人，父母和生命历程的SES与乳腺癌和宫颈癌筛查呈正相关，虽然教育为基础的SES措施是更强的预测筛选相比，就业为基础的措施。提高对癌症筛查益处的认识，并将癌症筛查纳入低社会经济地位妇女的常规医疗实践，是可采取的战略，可能会显着提高低收入和中等收入国家的筛查率。
OBJECTIVES: Socioeconomic differences in screening have been well documented in upper-income countries; however, few studies have examined socioeconomic status (SES) over the life-course in relation to cancer screening in lower-income and middle-income countries. Here, we examine individual, parental and life-course SES differences in breast and cervical cancer screening among women in India, China, Mexico, Russia and South Africa.SETTING: Data from the WHO's Study on Global Ageing and Adult Health (SAGE) 2007-2008 data were used for survey-weighted multivariable regression analysis. We examined the association between individual, parental and life-course SES in relation to breast and cervical cancer screening using education-based and employment-based measures of SES.PARTICIPANTS: 22 283 women aged 18-65 years, recruited from China, India, Mexico, Russia and South Africa.RESULTS: Having a college degree (OR 4.18; 95% CI 2.36 to 7.40) increased the odds of breast cancer screening compared with no formal education. Women with higher parental SES were almost 10 times more likely to receive breast cancer screening (OR 9.84; 95% CI 1.75 to 55.5) compared with women with low parental SES. Stable higher life-course (OR 3.07; 95% CI 1.96 to 4.79) increased breast cancer screening by threefold and increased cervical cancer screening by more than fourfold (OR 4.35; 95% CI 2.94 to 6.45); however, declining life-course SES was associated with reduced breast cancer screening (OR 0.26; 95% CI 0.08 to 0.79) compared to low life-course SES.CONCLUSIONS: Higher individual, parental and life-course SES was positively associated with breast and cervical cancer screening, although education-based SES measures were stronger predictors of screening compared with employment-based measures. Improving knowledge of the benefits of cancer screening and integrating cancer screening into routine healthcare practice for low SES women are actionable strategies that may significantly improve screening rates in low-income and middle-income countries.