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泰国曼谷丁当社区女性宫颈癌筛查的知识、态度和行为:一项基于社区的横断面研究。

Knowledge, attitudes and practices regarding cervical cancer screening among women in the Dindaeng community, Bangkok, Thailand: a cross-sectional community-based study.

作者信息

Oranratanaphan Shina, Moonchai Kamonchanok, Pohthipornthawat Natkrita, Santibenchakul Somsook, Phoolcharoen Natacha

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Srisavarindhira Thai Red Cross Institute of Nursing, Bangkok, Thailand.

出版信息

BMJ Open. 2025 Aug 31;15(8):e100896. doi: 10.1136/bmjopen-2025-100896.

Abstract

OBJECTIVES

To assess knowledge, attitudes and practices regarding cervical cancer screening among women in Bangkok's Dindaeng community and identify factors influencing screening uptake.

DESIGN

Cross-sectional, community-based survey.

SETTING

Primary care level; conducted in a high-density, low-income urban community in Bangkok, Thailand.

PARTICIPANTS

A total of 450 women aged 25-65 years were recruited using convenience sampling. After excluding ineligible participants (eg, prior hysterectomy), 428 women completed the questionnaire. All participants were literate in Thai and resided in the study area.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was a history of cervical cancer screening (ever screened vs never screened). Secondary outcomes included frequency of screening, barriers to screening and level of knowledge regarding cervical cancer and human papillomavirus (HPV).

RESULTS

Among 428 participants (mean age 47.9±11.2 years), 65.4% reported ever having been screened, but only 19.1% adhered to regular screening intervals. The most common barriers to screening were the absence of symptoms (54.7%) and fear of the procedure (42.1%). Only 31.8% correctly identified HPV as the cause of cervical cancer, and 23.8% were aware of the HPV vaccine. Higher knowledge scores were associated with having fewer children (adjusted OR (AOR) = 10.71; 95% CI: 1.29 to 89.12), while oral contraceptive use was negatively associated with high knowledge scores (AOR=0.14; 95% CI: 0.03 to 0.74).

CONCLUSIONS

Despite a moderate rate of screening uptake, consistent adherence and knowledge regarding cervical cancer and its prevention remain suboptimal. Targeted community health education and structural interventions are needed to improve awareness and promote regular screening in low-income urban settings.

摘要

目的

评估曼谷丁当社区女性对宫颈癌筛查的知识、态度和行为,并确定影响筛查接受率的因素。

设计

基于社区的横断面调查。

地点

初级保健层面;在泰国曼谷一个高密度、低收入的城市社区进行。

参与者

采用便利抽样法招募了450名年龄在25至65岁之间的女性。排除不符合条件的参与者(如既往子宫切除术)后,428名女性完成了问卷调查。所有参与者均精通泰语且居住在研究区域。

主要和次要结局指标

主要结局是宫颈癌筛查史(曾筛查与未筛查)。次要结局包括筛查频率、筛查障碍以及对宫颈癌和人乳头瘤病毒(HPV)的知识水平。

结果

在428名参与者(平均年龄47.9±11.2岁)中,65.4%报告曾接受过筛查,但只有19.1%坚持定期筛查。最常见的筛查障碍是无症状(54.7%)和害怕检查(42.1%)。只有31.8%正确识别出HPV是宫颈癌的病因,23.8%知晓HPV疫苗。较高的知识得分与子女较少有关(校正比值比(AOR)=10.71;95%置信区间:1.29至89.12),而使用口服避孕药与高知识得分呈负相关(AOR=0.14;95%置信区间:0.03至0.74)。

结论

尽管筛查接受率处于中等水平,但对宫颈癌及其预防的持续坚持和知识水平仍不理想。需要有针对性的社区健康教育和结构性干预措施,以提高低收入城市地区的认识并促进定期筛查。

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