内蒙古鄂尔多斯汉族和蒙古族妇女乳腺癌筛查效果分析及筛查认知调查

发布时间：2018-04-28 12:48

  本文选题：乳腺 + 肿瘤　； 参考：《北京协和医学院》2017年硕士论文

【摘要】：研究目的收集内蒙古鄂尔多斯市汉族和蒙古族妇女乳腺癌流行病学基线信息,为后期随访队列建立基础。在基层医疗条件下,比较分析汉族和蒙古族妇女乳腺癌筛查情况,为乳腺癌筛查工作提供数据支持。调查当地妇女对乳腺癌的认知情况并探讨可能影响认知水平的因素,为进一步宣传教育工作提供参考。材料与方法采用乳腺临床检查和三维超声技术进行乳腺癌初筛,超声BI-RADS 0,4,5类患者进一步检查,以病理活检结果为金标准。计算汉族与蒙古族妇女筛查阳性率、乳腺癌检出率,探讨乳腺癌筛查的效果。分析内蒙古鄂尔多斯市参加乳腺癌筛查的汉族与蒙古族妇女在乳腺癌筛查认知及意愿方面的水平及差异。通过面对面问卷调查法,由经过培训的调查员对参加筛查的妇女进行一对一问卷调查。问卷内容包括:一般人口学信息、乳腺癌筛查认知、意愿及影响因素等信息。研究结果1.超声筛查乳腺癌结果:共纳入汉族妇女21400人,蒙古族妇女2511人。汉族和蒙古族妇女平均年龄分别为45.10±7.05岁和45.69±6.67岁。汉族妇女月经初潮年龄≥18岁、初次分娩年龄30岁、未曾怀孕、痛经、绝经以及有乳腺疾病史的比例均低于蒙古族妇女(均P0.001)。乳腺触诊结果显示,汉族妇女异常的比例高于蒙古族妇女(P0.001)。超声结果显示,汉族妇女乳房乳腺导管局限性扩张、肿块5cm、后方回声增强、有钙化的比例均低于蒙古族妇女(均P0.05)。汉族妇女乳腺在0/4/5类的比例低于蒙古族妇女(P=0.021,P=0.258)。X线摄影结果显示,汉族妇女致密型乳腺比例高于蒙古族妇女(P0.001)。此次筛查乳腺癌总检出率为83.64/10万,其中汉族妇女检出率79.44/10万,蒙古族妇女检出率119.47/10万。2.乳腺癌筛查认知结果:汉族和蒙古族妇女分别入组11162(88.2%)人和1495(11.8%)人,平均年龄分别为(45.4±7.1)岁和(45.4±6.8)岁。汉族妇女高学历(高中及以上)的比例低于蒙古族(P0.001)。汉族和蒙古族女性获得乳腺癌筛查消息的主要途径均来自家人或朋友,其他消息途径分布差异有统计学意义(P0.001)。汉族和蒙古族妇女从未参加过筛查的比例分别为4640(41.7%)和683(45.9%)(P=0.001)。汉族妇女乳腺自检率高于蒙古族(P0.001)。经多因素Logistic回归分析,拥有高学历、曾有乳腺疾病的女性乳腺癌筛查认知度高(均P0.001)。结论在汉族和蒙古族人群中乳腺癌筛查具有一定效果。汉族妇女乳腺癌筛查认知水平优于蒙古族,但整体乳腺癌认知水平较低,应加强乳腺癌筛查知识宣传,提高妇女主动参加筛查意识。
[Abstract]:Objective to collect the baseline epidemiological information of breast cancer in Han and Mongolian women in Ordos, Inner Mongolia. Under the condition of primary medical treatment, the breast cancer screening of Han and Mongolian women was compared and analyzed to provide data support for breast cancer screening. To investigate the local women's cognition of breast cancer and explore the factors that may affect their cognitive level, and to provide reference for further propaganda and education. Materials and methods mammary gland clinical examination and three dimensional ultrasound technique were used to screen breast cancer and further examination was performed in 5 types of patients with BI-RADS 0 and 4 cases. The results of pathological biopsy were taken as the gold standard. The positive rate of screening and the detection rate of breast cancer in Han and Mongolian women were calculated and the results of breast cancer screening were discussed. To analyze the level and difference of cognition and willingness of breast cancer screening among Han and Mongolian women in Erdos city, Inner Mongolia. Through face-to-face questionnaire, trained investigators conducted one-on-one questionnaires to women who participated in the screening. The questionnaire includes: general demographic information, breast cancer screening cognition, willingness and influencing factors. Results 1. The results of ultrasound screening for breast cancer included 21400 Han women and 2511 Mongolian women. The average ages of Han and Mongolian women were 45.10 卤7.05 and 45.69 卤6.67 years respectively. The rate of menarche age 鈮，

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