Evaluation For Breast Disease Screening Programme In Rural Women

Background and ObjectiveIn the resent years, the incidence of female breast cancer has been significantly increasing. Breast cancer is one of the most common malignancies among women. It is a serious threat to women’s lives and health. According to the statistical data of American Cancer Society in2012, breast cancer was the first diagnosed malignancy with an incidence of29%of all the female breast tumors. It was also the second cause of death in female malignant tumors with an incidence of14%, which was only second to lung cancer. According to the statistical data in China in2011, the incidence of female breast cancer was10.1/100,000,31.2%higher than1998and was increasing at2.4%a year. The death rate of female breast cancer was9.27/100,000in city, which was the first death rate in all kinds of female cancers. How to take effective measures to restrain the sustained, rapid rising of the female breast cancer incidence is a hot and difficult point.Fuyang, a developed town, was elected as a pilot area of the national female breast cancer check. This article embarks from Fuyang’s rural women breast cancer screening programs and understands the status of female breast diseases through the analysis of the screening results. Analyze the related factors of rural women’s breast cancer by the method of case-control. Analyze the screening program by the method of cost-effectiveness. Evaluate government transforming funds about the prevention and the control of female breast diseases. Provide the reference for health administrative departments to formulate female diseases’prevention and control policies.Object and methods1.screening objectives Random samples were obtained through multi-stage stratified sampling. The target population included35-59females from26villages in Lushan Street, Fuchun Street and Dayuan.2.screening methods Project surveyors educate screening objectives about health, and then register cases after obtaining the consent. A group trained medical workers did the breast disease screening after completing the case registration. Screening methods include:clinical physical examination, ultrasound mammary gland, breast X-ray photography and pathological diagnosis. Divide all the objectives into two groups:the positive group and the negative group, and then analyze these two groups.Describe each index between mammary gland disease group and the health control group with the help of the SPSS16.0software. Compare rates using χ2,Logistic regression analyses, then clarify related factors of female breast diseases.Use the project cost calculation method to calculate the cost of screening. Check out breast disease cases and breast cancer patients and then make them as an index of effect cost effect analysis. Evaluate the effect of breast cancer screening and the effect of different screening methods. Results1. the characteristics of the screening peopleIn the project implementation process, the number of the screening population was6167. But103of them due to the screening age and lack of information have been dropped. In the end, there were6064screening data used for data analysis.2. positive signs of the physical examination and pathological diagnosisAfter clinical visual diagnosis and palpation examination about6064cases, it found that there are4088cases having positive signs, so the positive rate is70.38%.After initial diagnosis, it found that there were4053cases having benign diseases,25cases having benign tumors and10cases having suspected malignant tumors.Do the ultrasound examination to2264cases,1722positive,542negative. The positive rate is76.05%.Do the Molybdenum target X-ray examination to439cases, finding1suspected case of cancer.Do the pathological diagnosis to59cases, finding1breast cancer cases. One is Left breast intraductal carcinoma with infiltrating ductal carcinoma, the other is WHO II.According to the clinical examination, ultrasound, mammography and pathological diagnosis, there were4183people with breast diseases.4111of them had benign diseases,70had benign tumors and2had cancers.3.risk factors of breast diseasesBy χ2analysis, statistical differences were observed in the following factors: location, age, education level, marriage status, age of getting married, occupation and financial status. No difference was observed in family history of cancer, weight and the source of medical fee. And conditioned multivariate logistic regression showed:high level education (OR=1.134,95%CI:1.035-1.243), regular work (OR=1.212,95%CI: 1.040～1.414), family history of cancer (OR=1.296,95%CI:1.077～1.560) were the risk factors of breast disease. Age(OR=0.916,95%CI:0.906～0.925)was the protective factor of breast diseases. Compared to Fuchun Street, Lushan Street (OR=1.701,95%CI:1.464～1.977) and Dayuan (OR=1.281,95%CI:1.118～1.469) had higher risks of breast diseases. Compared to healthy weight, BMI<18.5(OR=0.699,95%CI:0.516～0.948) was a protective factor, but24=BMI<28(OR=1.144,95%CI:1.002～1.306) and BMI=28(OR=1.300,95%CI:0.917～1.843)were the risk factors of breast diseases.4.cost-effectiveness analysis The entire screening fee was265511yuan, finding4183positive cases and2cases of breast cancer. The cost of finding each new patient was63.5yuan, and the cost of finding each patient of breast cancer was132755.5yuan.Direct medical cost of diagnosis was156666, accounting for59%of the entire fee. Clinical examination costed18192yuan, found4268positive cases (suspected). Finding each new patient costed4.3yuan. Ultrasound screening costed135840yuan, the number of confirmed positive cases (suspected) was1722. Confirming each case costed78.9yuan.Results1.The breast disease prevalence rate is high in Fuyang. Cyclomastopathy is the main breast disease. The breast cancer prevalence rate is higher than the national average, which should arouse the attention of the Public Health Administrative Department and take positive countermeasures.2.The factor analysis showed that:education level, occupation, family history of cancer and overweight were the risk factors of breast diseases. Healthy lifestyle, keeping a good mood, controlling weight and staying away from pollution should be advocated. 3.The cost-effectiveness analysis showed that:the cost of finding each new patient of breast disease was63.5yuan, and the cost of finding each patient of breast cancer was132755.5yuan.