吴旦平等

[摘要] 目的 分析乳腺癌筛查在早期乳腺癌诊断中的应用，了解农村适龄妇女乳腺癌筛查的知信行（KAP）现状，旨在探讨适合农村妇女乳腺癌筛查的服务模式。 方法 2013年1月～2014年12月采用整群抽样的方式选取常熟市辛庄地区农村妇女为筛查对象，通过社区-医院联动的乳腺筛查及乳腺癌预防KAP问卷调查的方式分析乳腺癌筛查及KAP现状，并对比分析乳腺癌初筛者与曾接受筛查者相关情况。 结果 本次共筛查2098名农村妇女，共检出乳腺癌82例，检出率为3.91%，曾接受筛查人群的检出率为2.23%，明显低于初次筛查人群4.43%（P < 0.05）；乳腺癌筛查的敏感性、特异性、准确性分别为91.8%、96.3%和94.3%；曾接受筛查者的乳腺癌知识、信念、行为得分均明显高于初次筛查者（P < 0.05）。 结论 社区卫生服务机构-医院联动的筛查模式，可有效提高农村妇女乳腺癌的早诊早治率，同时应进一步加强农村妇女乳腺癌防治知识的宣传教育。

[关键词] 乳腺癌；筛查；早期诊断；知信行；调查

[中图分类号] R734 [文献标识码] A [文章编号] 1673-7210（2015）06（b）-0035-04

Application of breast cancer screening for rural women in China in early diagnosis of breast cancer and status of knowledge， attitude and practice

WU Danping1 ZHANG Hongdan1 FU Wei2 WANG Bo1 SHANG Jiangfeng1 SONG Jia1

1.Department of Thyroid Breast Surgery， No.1 People's Hospital of Changshu， Jiangsu Province， Changshu 215500， China； 2.Department of Oncology， No.1 People's Hospital of Changshu， Jiangsu Province， Changshu 215500， China

[Abstract] Objective To investigate application of breast cancer screening in early diagnosis of breast cancer， understand the status of knowledge， attitude and practice （KAP） of age women in rural areas， aimed to explore suitable service mode of breast cancer screening in rural areas. Methods With the method of cluster sampling， rural women in Xinzhuang District of Changshu City were selected as screening objects. During January 2013 to December 2014， the breast cancer screening and status of KAP were analyzed through breast screening based on the linkage of community-hospital and KAP questionnaire， and the relevant information between preliminary screening population and multiple screening population was comparatively analyzed. Results Of 2098 women in rural areas， 82 cases of breast cancer were detected， the detection rate was 3.91%. The detection rates in preliminary screening group and multiple screening group were 2.23%， 4.43%， with statistically significant difference （P < 0.05）. The sensitivity， specificity and accuracy of breast cancer screening was 91.8%， 96.3% and 94.3% respectively. The scores of knowledge， attitude and practice in preliminary screening group were significantly higher than those in multiple screening group （P < 0.05）. Conclusion Screening model based on community health service center-hospital， can effectively improve the rates of early diagnosis and early treatment of breast cancer in age women in rural areas， at the same time the propaganda and education of prevention knowledge to breast cancer should be strengthened.

[Key words] Breast cancer； Screening； Early diagnosis； KAP； Survey

乳腺癌是全球范围内女性癌症的第一杀手，据WHO国际癌症研究中心的最新数据估计，我国乳腺癌的平均发病率为35/10万～45/10万，并以3%的速度增加，农村升高幅度高于城市，且发病年龄呈年轻化趋势[1-2]。目前，乳腺癌尚缺乏有效的病因预防措施，但却是可以通过早期筛查、早发现癌前病变或早期癌症而降低病死率的恶性肿瘤之一[3-4]。我国乳腺癌筛查起步较晚，筛查技术也尚在探索阶段，不同地区乳腺癌筛查及相关知识的普及程度悬殊较大，尤其是农村地区受经济条件的影响，妇女自我保健意识较差，定期检查机会少[5-6]，且针对农村妇女乳腺癌预防知信行的调查仍鲜有报道。本研究拟通过对常熟市40～60周岁的农村妇女开展乳腺癌免费筛查，并了解乳腺癌预防知信行现状，旨在为探索一套适合常熟市农村妇女乳腺癌筛查的服务模式提供参考依据。……