| Objective(s):To understand the current situation of knowledge cognition and screening of cervical cancer among school-age women in rural areas of Yunnan Province,explore the main influencing factors of cognition and screening,provide reference for the government and health administration departments to formulate prevention and control policies suitable for local conditions,so as to improve the coverage rate of cervical cancer screening and early diagnosis and treatment in Yunnan Province,and promote the vaccination of HPV vaccine among women aged 9-14 years.Reduce the overall incidence and mortality of cervical cancer in Yunnan Province.Methods:According to the economic level of various states and cities in Yunnan Province,this survey selected three states and cities:Yuxi City(high),Lijiang City(middle),and Wenshan Prefecture(low).Each state and city selected one county district,each county district selected three townships,and each township selected three villages.Finally,a total of 27 villages were selected as the survey site.From February to May 2022,a questionnaire survey was conducted among women aged 18-64 who met the inclusion criteria at the survey site to collect basic information about the respondents,knowledge about cervical cancer,cervical cancer screening and HPV vaccination,and attitudes towards screening and vaccination.Epidata 3.0 was used to enter the questionnaire,and SPSS 20.0 was used to sort and analyze the data.Descriptive statistical analysis was carried out on the county,age,education background,etc.of the respondents.Chi-square test,analysis of variance,and binary logistic regression were used for single and multiple factor analysis.Results:1.There are 2874 valid respondents in this survey,including 1259 in Tonghai County(43.81%),704 in Yulong County(24.50%),and 911 in Guangnan County(31.70%),with an average age of 41.48±11.74 years.The awareness rate of cervical cancer related knowledge among respondents was 50.71%.Among them,county level,age,educational background,annual family income,and fertility status are the influencing factors for the awareness rate of cervical cancer related knowledge The awareness rate of women aged 30 is higher than that of women aged ≥ 50(OR=0.66,95%CI:0.47-0.92);The awareness rate of women in Guangnan County is lower than that in Tonghai County(OR=0.69,95%CI:0.55-0.88);The awareness rate of women with primary school,junior high school,high school/technical secondary school,university or above education is higher than that of illiterate or semi illiterate individuals(OR=1.76,95%CI:1.24-2.52;OR=2.30,95%CI:1.60-3.31;OR=3.65,95%CI:2.37-5.63;OR=5.25,95%CI:3.14-8.77),respectively,compared to illiterate or semi illiterate women;The awareness rate of women with an annual household income of<5000 yuan is lower than 10001-15000 yuan(OR=1.50,95%CI:1.08-2.10);The awareness rate of women who gave birth to 1 child and ≥ 2 children was 1.62 times(OR=1.62,95%CI:1.11-2.35)and 1.49 times(OR=1.49,95%CI:1.01-2.19)higher than that of women who did not give birtlh,respectively.2.The results of this survey show that the tota average score of the healt h belief scale for screening and HPV vaccine is 3.73±0.42 points,with the ave rage scores of 3.9±0.68 points,4.02±0.74 points,3.64±0.65 points,2.72±0.69 p oints,4.00±0.59 points,3.1±0.84 points,and 3.9±0.57 points for each dimensio n of disease susceptibility perception,disease severity perception,vaccine benefi t perception,vaccine hindrance perception,screening benefit perception,and be havioral suggestion,respectively.3.Among 2,874 respondents,1,559(54.24%)participated in cervical cancer screening,and 1,315(45.76%)did not,26.30%participated once and 27.94%participated twice.Among the people who participated in the screening once,the highest proportion of all kinds of characteristics were 40-49 years old(35.71%),junior high school education(45.37%),farmers(90.61%)and married(96.83%).Among the people who have participated in the screening for≥2 times,the highest proportion of various characteristics are≥50 years old(40.60%),junior high school education(38.11%),farmers(87.05%)and married(93.27%).The composition of screening times of people with different ages,educational background,occupations and marital status is different;The last screening time was less than three years(87.36%)and more than three years(12.64%).Free screening organized by unit/community/village committee is the main form of participating in screening(89.42%),and the way of obtaining screening information is mainly informed by the surrounding people(79.54%).The highest reason for not participating in screening is"no time to do screening"(41.52%).4.The analysis of screening influencing factors showed that the screening rate in Tonghai County was higher than that in Yulong County and Guangnan County(OR=0.39,95%CI:0.30-0.50;OR=0.74,95%CI:0.57-0.95);Compared with the<30 year old age group,the screening rates of 30-39 years old,40-49 years old,and ≥50 years old are higher than those of the<30 year old age group(OR=3.35,95%CI:2.43-4.62;OR=12.96,95%CI:9.09-18.46;OR=12.70,95%CI:8.80-18.31);The screening rate of farmers is lower than that of other occupations(OR=0.68,95%CI:0.50-0.91);The screening rate of women who give birth to one child and ≥ two children is higher than that of rural women who have not given birth(OR=2.46,95%CI:1.54-3.92;OR=2.63,95%CI:1.64-4.22);The screening rate of women who did not know about cervical cancer was lower than those who did(OR=2.20,95%CI:1.76-2.74);The higher the scores for screening benefits,screening barriers,and behavioral cues for cervical cancer,the higher the screening rate(OR=1.14,95%CI:1.03-1.25;OR=1.08,95%CI:1.04-1.13;OR=1.11,95%CI:1.06-1.17).5.In this survey,the proportion of people who have been vaccinated with HPV vaccine is 1.74%,the proportion of people who have not been vaccinated with HPV vaccine is 98.26%,and the proportion of people who have been vaccinated with bivalent HPV vaccine is the highest(44%);In terms of age,no rural women aged 50 or above were vaccinated with HPV vaccine,and the vaccination rates in the age groups<30,3 0-39,and 40-49 were 4.26%,1.53%,and 1.93%,respectively.There was a statistically significant difference in HPV vaccination among women of different age groups(χ2=42.31,P<0.01);There was a statistically significant difference in HPV vaccination rates among different marital status(χ2=8.52,P<0.01);The vaccination rate increased with the educational background of the respondents(χ2=70.54,P<0.01);The vaccination rate of HPV vaccine varies with different fertility status(χ2=42.97,P<0.01);The vaccination rate of women with knowledge about cervical cancer was higher than that of women without knowledge(χ2=5.00,P=0.03);The highest proportion of reasons for choosing to receive HPV vaccine was "self-understanding and decision making"(72%),while the highest proportion of reasons for not receiving HPV vaccine was "not understanding HPV vaccine"(46.42%).Among the respondents who were not vaccinated with HPV vaccine,59.99%"can only accept free" HPV vaccine ",and 25.92%can accept" up to 500 yuan ".Conclusion(s):1.In some rural areas of Yunnan Province,the awareness rate of cervical cancer related knowledge among school-age women is low,and the knowledge gap of cervical cancer prevention and treatment is large.Therefore,it is necessary to strengthen the popularization of cervical cancer prevention and control knowledge for women of the appropriate age in rural areas,and it is necessary to provide them with scientific,complete and correct cervical cancer prevention and control knowledge.2.Region,age,educational level,family annual income and fertility status are the factors influencing the knowledge rate of cervical cancer.The knowledge rate of high economic development level,young women,high educational level,higher income and people who have given birth is higher.3.County,age,occupation,fertility status,knowledge,health belief perception of screening benefits,perception of screening obstacles,and behavioral suggestion are the factors affecting cervical cancer screening in rural areas of Yunnan province.4.The vaccination rate among women of appropriate age in some rural areas of Yunnan Province is very low.Although cervical cancer screening is steadily improving,there is still a long way to go from the target set out in the Strategy for Accelerating the elimination of Cervical cancer.5.County,age,occupation,fertility status,knowledge awareness,perception of screening benefits in health beliefs,perception of screening obstacles and behavioral suggestion are independent influencing factors of cervical cancer screening rate. |
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