Reduced likelihood of cancer screening among women in urban areas and with low socio-economic status: A multilevel analysis in Japan
Reduced likelihood of cancer screening among women in urban areas and with low socio-economic status: A multilevel analysis in Japan
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DOI：
10.1016/j.puhe.2005.03.013
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发表时间：
2005-10-01
期刊：
影响因子：
5.2
通讯作者：
Takano, T
中科院分区：
文献类型：
--
作者：
Fukuda, Y;Nakamura, K;Takano, T
目的：阐明日本妇女参与癌症筛查的社会经济预测因素，关注地区差异。方法：以具有全国代表性的40-年龄段的日本女性(n=15,224)为样本，采用多水平分析的方法，分析自述的胃癌、结肠癌、子宫癌和乳腺癌筛查就诊率与个人特征(婚姻状况、职业和家庭收入)和地区变量(是否居住在大都市、人均收入)之间的关系。结果：结肠癌的参与率为21.6%，子宫癌的参与率为32.5%。已婚、有工作、家庭收入较高与所有类型癌症的癌症筛查可能性显著相关：与收入最高的五分之一相比，收入最低的五分之一的调整后的优势比从子宫癌的0.45到结肠癌的0.53不等。有显著的地区差异，生活在大都市地区和人均收入与癌症筛查的可能性降低相关。结论：在日本，社会经济地位较低和居住在城市地区的女性参与癌症筛查的可能性较小。考虑到社会经济不平等，应鼓励在城市地区进行癌症筛查。(C)2005年皇家公共卫生研究所。爱思唯尔有限公司出版。版权所有。
Objectives: To elucidate socio-economic predictors of participation in cancer screening in Japanese women, paying attention to regional variations. Methods: In a nationally representative sample of women aged 40-64 years (n = 15,224) in Japan, the relationships of self-reported attendance at screening for stomach, colon, uterine and breast cancers with individual characteristics (marital status, occupation and household income) and regional variables (living in a metropolitan area or not, and per capita income) were examined using multilevel analysis.Results: The participation rate ranged from 21.6% for colon cancer to 32.5% for uterine cancer. Being married, employed and having a higher household income were significantly associated with a higher likelihood of cancer screening for all types of cancer: the adjusted odds ratio in the lowest income quintile ranged from 0.45 for uterine cancer to 0.53 for colon cancer compared with the highest income quintile. There was significant regional variance, and living in a metropolitan area and per capita income were associated with a reduced likelihood of cancer screening.Conclusions: Women with lower socio-economic status and living in urban areas are less likely to participate in cancer screening in Japan. Cancer screening should be encouraged in urban areas, taking account of the socio-economic inequalities. (c) 2005 The Royal Institute of Public Health. published by Elsevier Ltd. All rights reserved.