Profile And Predictors Of Breast Cancer Opportunistic Screening Utilization Among Female In Tianjin Community

Objective: To understand the reproductive health status and prevalence of breast disease among married women in a community in Tianjin from 2009 to 2017.Choosing part of women interviewed with a structured questionnaire to investigate the profile of breast cancer opportunistic screening,aiming to provide basic data and references for for organized breast cancer screening and other cancer screening projects.Methods: The results of 2009-2017 general investigation of gynecological disease of 27446 married women in a community in Tianjin were collected and analyzed to compare the tendency of women's gynecological and breast disease in different age and year groups.A total of 1100 female were interviewed with a structured questionnaire that included questions about sociodemographic factors,physiological features,history of disease,living habits,breast cancer screening behaviors and so on,in order to comprehend breast cancer screening utilization status.Traditional logistic models and lasso logistic model was used to analyze the predictors of breast self-examination,clinical breast examination,mammography and breast ultrasonography.Results: 1.Overview of gynecological examination: The number of women accepted gynecological examination from 2009 to 2017 were 27446,and were between 1498 and 4239.Women aged 50 to 59 were the majority of those who accepted gynecological examination.The prevalence of gynecological disease was between 35.6% and 76.1%.The prevalence of gynecological diseaseas decreasing from 2009 to 2017.The prevalence of gynecological disease among women aged 30-49 was higher and among women aged 60-65 was lower respectively.The prevalence of breast disease was decreasing before 2012,and was increasing after 2012 as a whole.The prevalence of breast disease among women aged 35-49(37.1%)was higher than those aged 50-65(23.2%).Mammary gland hyperplasia was the most common breast disease.Seven cases of breast cancer were detected among 2009-2017.The detection rate of breast cancer was 25.62/1000,000.2.Breast cancer screening: Of the 1100 original women invited,672(61.1%)women heard about breast cancer screening.1019(92.6%)had attended clinical breast examination.297(27%)had attended ultrasonography,and 7.9% had attended mammography.28.9% of women attended opportunistic screening based on our definition.Factors associated with breast cancer opportunistic screening utilization were personal history of breast disease,history of induced abortion,BMI,time to community hospitals and awareness of breast cancer screening all found in traditional logistic models and Lasso logistic model.The cross validation resulted in ?=0.025 for Lasso logistic model.Conclusions: The number of women accepted gynecological examination were depended on the amount of tasks prescribed by parent business.The majority were the women aged 50-65.The prevalence of gynecological disease in general was decreasing from 2009 to 2017,and women aged 30-49 had higher prevalence.The prevalence of breast disease among women aged 35-49 was higher than those aged 50-65.Mammary gland hyperplasia was the most common breast disease.It was significant to improve women's consciousness of health care by conducting gynecological examination and targeted health education on the related knowledge about gynecological disease.This study revealed that breast cancer opportunistic screening utilization rate among community female in Tianjin was rather low,only 28.9%.Lower educational status,lower income level,history of induced abortion and breast disease,obesity,poor breast cancer awareness and lower perceived risk were predictors of lower opportunistic screening utilization rate.To improve screening utilization,attention should focus on targeting vulnerable individuals,especially with lower educational attainment and income level,no personal history of breast disease,and obesity.Health extension workers should promote breast health education by focus on the knowledge about breast cancer risk factors in order to promote more female attend breast cancer screening,which in turn would have the impact to improve the level of breast cancer.