Article(id=1324050984506368452, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202601299, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1768838400000, receivedDateStr=2026-01-20, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793607954383, onlineDateStr=2026-11-02, pubDate=1781020800000, pubDateStr=2026-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793607954383, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793607954383, creator=13701087609, updateTime=1793607954383, updator=13701087609, issue=Issue{id=1324050876230415089, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='11', pageStart='1921', pageEnd='2112', issueExtLink='null', onlineDate='null', pubDate='1781020800000', pubDateStr='2026-06-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793607928569, creator='13701087609', updateTime=1793670049253, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324311429322507008, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324311429322507009, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324050876230415089, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2013, endPage=2017, ext={EN=ArticleExt(id=1324050986343473605, articleId=1324050984506368452, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Screening compliance and its influencing factors among urban populations at high risk of breast cancer in Nanchang City from 2021 to 2023, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the compliance of urban populations at high risk of breast cancer in Nanchang City from 2021 to 2023 and explore potential influencing factors, in order to provide a scientific basis for improving screening participation rates and optimizing screening strategies.

Methods

Permanent registered residents aged 45-74 years in Nanchang City were selected for a breast cancer risk factor survey and risk assessment. Individuals assessed as high-risk for breast cancer were recommended to undergo combined breast ultrasound and X-ray examinations at designated hospitals. SPSS 25.0 was used to perform χ2 analysis to compare screening participation rates across groups with different characteristics. Multivariable logistic stepwise regression analysis was also conducted to identify factors associated with screening participation.

Results

A total of 9 138 high-risk individuals for breast cancer were enrolled, of whom 4 228 participated in breast cancer screening, yielding an overall participation rate of 46.27%. Multivariable logistic stepwise regression analysis showed that higher education level (OR=1.235, 95% CI: 1.052-1.450), current smoking (OR=1.519, 95% CI: 1.296-1.779), exposure to secondhand smoke (OR=1.784, 95% CI: 1.621-1.964), history of childbirth (OR=2.631, 95% CI: 2.141-3.233), history of benign breast disease (OR=1.846, 95% CI: 1.683-2.025), and family history of breast cancer in blood relatives (OR=1.560, 95% CI: 1.406-1.731) were facilitating factors for screening participation (P<0.05). In contrast, age 65-74 years (OR=0.572, 95% CI: 0.508-0.645), screening in 2022 (OR=0.644, 95% CI: 0.573-0.724) and 2023 (OR=0.709, 95% CI: 0.637-0.789), engaging in physical exercise ≥3 times per week (OR=0.763, 95% CI: 0.691-0.844), and history of breastfeeding (OR=0.882, 95% CI: 0.803-0.970) were inhibiting factors for screening participation (P<0.05).

Conclusion

The screening rate among urban populations at high risk of breast cancer in Nanchang City was relatively low and influenced by multiple factors, including education level, smoking history, childbirth history, breastfeeding history, physical exercise, and family history of breast cancer. It is recommended to adopt targeted health education, strengthen social support networks, and focus on subgroups with low screening participation in future efforts to improve screening coverage and enhance prevention and control outcomes.

, authors=Kun ZHOU1, Xiao-ling ZHU1, Yu-Hong LIU1, Su-dan WANG1, Jia-ming ZHAO1, Jing LIANG1, Xiao-bo WANG2, Wen-Yan XIONG1, authorsList=Kun ZHOU, Xiao-ling ZHU, Yu-Hong LIU, Su-dan WANG, Jia-ming ZHAO, Jing LIANG, Xiao-bo WANG, Wen-Yan XIONG, authorCompany=null, correspAuthors=Wen-Yan XIONG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324050986796458438, articleId=1324050984506368452, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=2021—2023年南昌市城市乳腺癌高危人群筛查依从性及其影响因素分析, columnId=1228016570031604578, journalTitle=现代预防医学, columnName=儿少卫生与妇幼保健, runingTitle=null, highlight=null, articleAbstract=
目的

分析2021—2023年南昌市城市乳腺癌高危人群筛查依从性并探索可能的影响因素,为提升人群筛查参与率、优化筛查策略提供科学依据。

方法

选取南昌市45~74岁常住户籍居民开展乳腺癌危险因素调查并进行风险评估,建议评估为乳腺癌高危人群者在定点医院行乳腺超声联合X线检查。采用SPSS 25.0 软件,通过χ2检验分析不同特征人群的筛查参与率的差异,并采用多因素logistic逐步回归模型分析与筛查参与率相关影响因素。

结果

共纳入9 138名乳腺癌高危人群,其中参加乳腺癌筛查的共4 228人,总体参与率为46.27%。多因素logistic逐步回归分析结果显示,文化程度高(OR=1.235,95% CI:1.052~1.450 )、目前仍在吸烟(OR=1.519,95% CI:1.296~1.779)、有二手烟暴露史(OR=1.784,95% CI:1.621~1.964)、有生育史(OR=2.631,95% CI:2.141~3.233)、有良性乳腺疾病史(OR=1.846,95% CI:1.683~2.025)以及有血缘亲属乳腺癌史(OR=1.560,95% CI:1.406~1.731)的高危人群是筛查参与的促进因素(P<0.05)。年龄在65~74岁(OR=0.572,95% CI:0.508~0.645),筛查年度在2022年(OR=0.644,95% CI:0.573~0.724)及2023年(OR=0.709,95% CI:0.637~0.789)、每周进行体育锻炼≥3次(OR=0.763,95% CI:0.691~0.844)、有哺乳史(OR=0.882,95% CI:0.803~0.970)的高危人群是筛查参与的不利因素(P<0.05)。

结论

南昌市城市乳腺癌高危人群筛查率偏低。筛查率受文化程度、吸烟史、生育史、哺乳史、体育锻炼及血缘亲属乳腺癌史等多因素影响。建议未来采取针对性健康教育、强化社会支持网络、重点关注筛查率低下亚群等综合策略,以提升筛查覆盖率与防控效果。

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周坤(1992—),男,硕士,主管医师,研究方向:慢性病预防与控制

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熊文艳,E-mail:
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Human Movement, 2021, 22(2): 6., articleTitle=Physical exercise and sex steroid hormones in breast cancer, refAbstract=null)], funds=[Fund(id=1324050997965890053, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, awardId=2025022430, language=CN, fundingSource=江西省中医药管理局科技计划项目(2025022430), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1324050987069088199, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, xref=1., ext=[AuthorCompanyExt(id=1324050987077476808, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, companyId=1324050987069088199, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Jiangxi Provincial Key Laboratory of Animal-origin and Vector-borne Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, Jiangxi 330038, China), AuthorCompanyExt(id=1324050987102642633, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, companyId=1324050987069088199, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.传染病预防控制国家重点实验室研究基地、江西省动物源与媒介生物性传染病重点实验室、南昌市疾病预防控制中心,江西 南昌 330038)]), AuthorCompany(id=1324050987190723018, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, xref=2., ext=[AuthorCompanyExt(id=1324050987203305931, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, companyId=1324050987190723018, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.江西省肿瘤医院)])], figs=[ArticleFig(id=1324050997504516609, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, language=EN, label=Table 1, caption=

Univariate analysis of breast cancer screening participation rates in Nanchang City from 2021 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
变量风险评估人群高风险人群筛查人群筛查率( % )χ2值P值
年龄(岁)230.61<0.001
45~547 1183 5481 78450.28
55~646 4643 4161 74651.11
65~746 3982 1746 9832.11
民族0.200.653
汉族19 9659 1354 22746.27
其他153133.33
年份(年)90.04<0.001
20218 1493 5021 84052.54
20224 8382 4111 02942.68
20236 9933 2251 35942.14
BMI(kg/m2)11.810.008
<18.54962168840.74
18.5~23.911 8275 2582 48247.20
24.0~27.95 9922 8551 32246.30
≥28.01 66580933641.53
文化程度11.990.002
小学及以下8 6933 5641 57144.08
初/高中9 8374 6902 22447.42
大专及以上1 45088443348.98
婚姻状况12.47<0.001
已婚19 8809 0704 21146.43
未婚100681725.00
吸烟史59.88<0.001
从不吸烟18 7318 1563 66544.94
曾吸烟已戒断96672943.28
当前吸烟1 15391553458.36
二手烟暴露史347.48<0.001
无12 0073 9891 40535.22
有7 9735 1492 82354.83
饮酒史35.21<0.001
从不饮酒17 1357 1113 17444.64
曾饮酒已戒酒2317741.18
当前饮酒2 8222 0101 04752.09
体育锻炼(次/周)33.95<0.001
<311 0896 1972 99748.36
≥38 8912 9411 23141.86
初潮年龄(岁)3.200.074
<1258857224442.66
≥1219 3928 5663 98446.51
绝经状态0.290.588
否5 0922 4781 15846.73
是14 8886 6603 07046.10
生育史238.19<0.001
无92573213918.99
有19 0558 4064 08948.64
哺乳史9.880.020
无4 9503 5961 73748.30
有15 0305 5422 49144.95
良性乳腺疾病史361.94<0.001
无16 4515 6612 17938.49
有3 5293 4772 04958.93
血缘亲属乳腺癌史217.46<0.001
无17 2836 4662 67241.32
有2 6972 6721 55658.23
血缘亲属卵巢癌史4.570.330
无19 3838 6063 95845.99
有59753227050.75
), ArticleFig(id=1324050997605179906, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, language=CN, label=表1, caption=

2021-2023年度南昌市乳腺癌筛查参与率的单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量风险评估人群高风险人群筛查人群筛查率( % )χ2值P值
年龄(岁)230.61<0.001
45~547 1183 5481 78450.28
55~646 4643 4161 74651.11
65~746 3982 1746 9832.11
民族0.200.653
汉族19 9659 1354 22746.27
其他153133.33
年份(年)90.04<0.001
20218 1493 5021 84052.54
20224 8382 4111 02942.68
20236 9933 2251 35942.14
BMI(kg/m2)11.810.008
<18.54962168840.74
18.5~23.911 8275 2582 48247.20
24.0~27.95 9922 8551 32246.30
≥28.01 66580933641.53
文化程度11.990.002
小学及以下8 6933 5641 57144.08
初/高中9 8374 6902 22447.42
大专及以上1 45088443348.98
婚姻状况12.47<0.001
已婚19 8809 0704 21146.43
未婚100681725.00
吸烟史59.88<0.001
从不吸烟18 7318 1563 66544.94
曾吸烟已戒断96672943.28
当前吸烟1 15391553458.36
二手烟暴露史347.48<0.001
无12 0073 9891 40535.22
有7 9735 1492 82354.83
饮酒史35.21<0.001
从不饮酒17 1357 1113 17444.64
曾饮酒已戒酒2317741.18
当前饮酒2 8222 0101 04752.09
体育锻炼(次/周)33.95<0.001
<311 0896 1972 99748.36
≥38 8912 9411 23141.86
初潮年龄(岁)3.200.074
<1258857224442.66
≥1219 3928 5663 98446.51
绝经状态0.290.588
否5 0922 4781 15846.73
是14 8886 6603 07046.10
生育史238.19<0.001
无92573213918.99
有19 0558 4064 08948.64
哺乳史9.880.020
无4 9503 5961 73748.30
有15 0305 5422 49144.95
良性乳腺疾病史361.94<0.001
无16 4515 6612 17938.49
有3 5293 4772 04958.93
血缘亲属乳腺癌史217.46<0.001
无17 2836 4662 67241.32
有2 6972 6721 55658.23
血缘亲属卵巢癌史4.570.330
无19 3838 6063 95845.99
有59753227050.75
), ArticleFig(id=1324050997726814723, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, language=EN, label=Table 2, caption=

Multivariable stepwise logistic regression analysis of breast cancer screening participation rates in Nanchang City from 2021 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
因素βOR(95% CI)P值
年龄(岁)
45~54
55~640.0201.020(0.923-1.127)0.696
65~74-0.5580.572(0.508-0.645)<0.001
年份(年)
2021
2022-0.4400.644(0.573-0.724)<0.001
2023-0.3440.709(0.637-0.789)<0.001
BMI(kg/m2)
<18.5
18.5~23.90.2281.256(0.937-1.686)0.128
24.0~27.90.1691.184(0.879-1.597)0.267
≥28.00.0271.028(0.743-1.421)0.869
文化程度
小学及以下
初/高中0.0461.047(0.951-1.153)0.347
大专及以上0.2111.235(1.052-1.450)0.010
婚姻状况
已婚
未婚-0.3260.722(0.398-1.309)0.283
吸烟史
从不吸烟
曾吸烟已戒断-0.1750.840(0.506-1.395)0.500
当前吸烟0.4181.519(1.296-1.779)<0.001
二手烟暴露史
无
有0.5791.784(1.621-1.964)<0.001
饮酒史
从不饮酒
曾饮酒已戒酒0.3971.488(0.551-4.013)0.433
当前饮酒-0.0610.941(0.839-1.056)0.302
体育锻炼(次/周)
<3
≥3-0.2700.763(0.691-0.844)<0.001
生育史
无
有0.9672.631(2.141-3.233)<0.001
哺乳史
无
有-0.1250.882(0.803-0.970)0.010
良性乳腺疾病史
无
有0.6131.846(1.683-2.025)<0.001
血缘亲属乳腺癌史
无
有0.4451.560(1.406-1.731)<0.001
血缘亲属卵巢癌史
无
有-1.4840.822(0.677-0.107)0.051
), ArticleFig(id=1324050997835866628, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324050984506368452, language=CN, label=表2, caption=

2021-2023年度南昌市乳腺癌筛查参与率的的多因素logistic逐步回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
因素βOR(95% CI)P值
年龄(岁)
45~54
55~640.0201.020(0.923-1.127)0.696
65~74-0.5580.572(0.508-0.645)<0.001
年份(年)
2021
2022-0.4400.644(0.573-0.724)<0.001
2023-0.3440.709(0.637-0.789)<0.001
BMI(kg/m2)
<18.5
18.5~23.90.2281.256(0.937-1.686)0.128
24.0~27.90.1691.184(0.879-1.597)0.267
≥28.00.0271.028(0.743-1.421)0.869
文化程度
小学及以下
初/高中0.0461.047(0.951-1.153)0.347
大专及以上0.2111.235(1.052-1.450)0.010
婚姻状况
已婚
未婚-0.3260.722(0.398-1.309)0.283
吸烟史
从不吸烟
曾吸烟已戒断-0.1750.840(0.506-1.395)0.500
当前吸烟0.4181.519(1.296-1.779)<0.001
二手烟暴露史
无
有0.5791.784(1.621-1.964)<0.001
饮酒史
从不饮酒
曾饮酒已戒酒0.3971.488(0.551-4.013)0.433
当前饮酒-0.0610.941(0.839-1.056)0.302
体育锻炼(次/周)
<3
≥3-0.2700.763(0.691-0.844)<0.001
生育史
无
有0.9672.631(2.141-3.233)<0.001
哺乳史
无
有-0.1250.882(0.803-0.970)0.010
良性乳腺疾病史
无
有0.6131.846(1.683-2.025)<0.001
血缘亲属乳腺癌史
无
有0.4451.560(1.406-1.731)<0.001
血缘亲属卵巢癌史
无
有-1.4840.822(0.677-0.107)0.051
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2021—2023年南昌市城市乳腺癌高危人群筛查依从性及其影响因素分析
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周坤 1 , 朱晓琳 1 , 刘宇虹 1 , 王苏丹 1 , 赵佳铭 1 , 梁静 1 , 王晓波 2 , 熊文艳 1
现代预防医学 | 儿少卫生与妇幼保健 2026,53(11): 2013-2017
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现代预防医学 |儿少卫生与妇幼保健 2026 , 53 (11) : 2013 -2017
2021—2023年南昌市城市乳腺癌高危人群筛查依从性及其影响因素分析
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周坤(1992—),男,硕士,主管医师,研究方向:慢性病预防与控制

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周坤1, 朱晓琳1, 刘宇虹1, 王苏丹1, 赵佳铭1, 梁静1, 王晓波2, 熊文艳1
作者信息
  • 1.传染病预防控制国家重点实验室研究基地、江西省动物源与媒介生物性传染病重点实验室、南昌市疾病预防控制中心,江西 南昌 330038
  • 2.江西省肿瘤医院
通讯作者:
熊文艳,E-mail:
作者简介:

周坤(1992—),男,硕士,主管医师,研究方向:慢性病预防与控制

Screening compliance and its influencing factors among urban populations at high risk of breast cancer in Nanchang City from 2021 to 2023
Kun ZHOU1, Xiao-ling ZHU1, Yu-Hong LIU1, Su-dan WANG1, Jia-ming ZHAO1, Jing LIANG1, Xiao-bo WANG2, Wen-Yan XIONG1
Affiliations
  • The Collaboration Unit for Field Epidemiology of State Key Laboratory for Infectious Disease Prevention and Control, Jiangxi Provincial Key Laboratory of Animal-origin and Vector-borne Diseases, Nanchang Center for Disease Control and Prevention, Nanchang, Jiangxi 330038, China
出版时间: 2026-06-10 doi: 10.20043/j.cnki.MPM.202601299
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目的

分析2021—2023年南昌市城市乳腺癌高危人群筛查依从性并探索可能的影响因素,为提升人群筛查参与率、优化筛查策略提供科学依据。

方法

选取南昌市45~74岁常住户籍居民开展乳腺癌危险因素调查并进行风险评估,建议评估为乳腺癌高危人群者在定点医院行乳腺超声联合X线检查。采用SPSS 25.0 软件,通过χ2检验分析不同特征人群的筛查参与率的差异,并采用多因素logistic逐步回归模型分析与筛查参与率相关影响因素。

结果

共纳入9 138名乳腺癌高危人群,其中参加乳腺癌筛查的共4 228人,总体参与率为46.27%。多因素logistic逐步回归分析结果显示,文化程度高(OR=1.235,95% CI:1.052~1.450 )、目前仍在吸烟(OR=1.519,95% CI:1.296~1.779)、有二手烟暴露史(OR=1.784,95% CI:1.621~1.964)、有生育史(OR=2.631,95% CI:2.141~3.233)、有良性乳腺疾病史(OR=1.846,95% CI:1.683~2.025)以及有血缘亲属乳腺癌史(OR=1.560,95% CI:1.406~1.731)的高危人群是筛查参与的促进因素(P<0.05)。年龄在65~74岁(OR=0.572,95% CI:0.508~0.645),筛查年度在2022年(OR=0.644,95% CI:0.573~0.724)及2023年(OR=0.709,95% CI:0.637~0.789)、每周进行体育锻炼≥3次(OR=0.763,95% CI:0.691~0.844)、有哺乳史(OR=0.882,95% CI:0.803~0.970)的高危人群是筛查参与的不利因素(P<0.05)。

结论

南昌市城市乳腺癌高危人群筛查率偏低。筛查率受文化程度、吸烟史、生育史、哺乳史、体育锻炼及血缘亲属乳腺癌史等多因素影响。建议未来采取针对性健康教育、强化社会支持网络、重点关注筛查率低下亚群等综合策略,以提升筛查覆盖率与防控效果。

乳腺癌  /  高危人群  /  筛查依从性  /  影响因素  /  南昌市
Objective

To analyze the compliance of urban populations at high risk of breast cancer in Nanchang City from 2021 to 2023 and explore potential influencing factors, in order to provide a scientific basis for improving screening participation rates and optimizing screening strategies.

Methods

Permanent registered residents aged 45-74 years in Nanchang City were selected for a breast cancer risk factor survey and risk assessment. Individuals assessed as high-risk for breast cancer were recommended to undergo combined breast ultrasound and X-ray examinations at designated hospitals. SPSS 25.0 was used to perform χ2 analysis to compare screening participation rates across groups with different characteristics. Multivariable logistic stepwise regression analysis was also conducted to identify factors associated with screening participation.

Results

A total of 9 138 high-risk individuals for breast cancer were enrolled, of whom 4 228 participated in breast cancer screening, yielding an overall participation rate of 46.27%. Multivariable logistic stepwise regression analysis showed that higher education level (OR=1.235, 95% CI: 1.052-1.450), current smoking (OR=1.519, 95% CI: 1.296-1.779), exposure to secondhand smoke (OR=1.784, 95% CI: 1.621-1.964), history of childbirth (OR=2.631, 95% CI: 2.141-3.233), history of benign breast disease (OR=1.846, 95% CI: 1.683-2.025), and family history of breast cancer in blood relatives (OR=1.560, 95% CI: 1.406-1.731) were facilitating factors for screening participation (P<0.05). In contrast, age 65-74 years (OR=0.572, 95% CI: 0.508-0.645), screening in 2022 (OR=0.644, 95% CI: 0.573-0.724) and 2023 (OR=0.709, 95% CI: 0.637-0.789), engaging in physical exercise ≥3 times per week (OR=0.763, 95% CI: 0.691-0.844), and history of breastfeeding (OR=0.882, 95% CI: 0.803-0.970) were inhibiting factors for screening participation (P<0.05).

Conclusion

The screening rate among urban populations at high risk of breast cancer in Nanchang City was relatively low and influenced by multiple factors, including education level, smoking history, childbirth history, breastfeeding history, physical exercise, and family history of breast cancer. It is recommended to adopt targeted health education, strengthen social support networks, and focus on subgroups with low screening participation in future efforts to improve screening coverage and enhance prevention and control outcomes.

Breast cancer  /  High-risk population  /  Screening compliance  /  Influencing factors  /  Nanchang City
周坤, 朱晓琳, 刘宇虹, 王苏丹, 赵佳铭, 梁静, 王晓波, 熊文艳. 2021—2023年南昌市城市乳腺癌高危人群筛查依从性及其影响因素分析. 现代预防医学, 2026 , 53 (11) : 2013 -2017 . DOI: 10.20043/j.cnki.MPM.202601299
Kun ZHOU, Xiao-ling ZHU, Yu-Hong LIU, Su-dan WANG, Jia-ming ZHAO, Jing LIANG, Xiao-bo WANG, Wen-Yan XIONG. Screening compliance and its influencing factors among urban populations at high risk of breast cancer in Nanchang City from 2021 to 2023[J]. Modern Preventive Medicine, 2026 , 53 (11) : 2013 -2017 . DOI: 10.20043/j.cnki.MPM.202601299
乳腺癌是全球女性中最常见的恶性肿瘤[1]。在我国,乳腺癌是女性发病率第二位的恶性肿瘤,也是导致中国女性癌症死亡的第五大原因,乳腺癌所造成的疾病负担仍在逐年上升[2-3]。乳腺超声与乳腺X线检查作为公认的乳腺癌早期筛查方法,是降低乳腺癌死亡率的关键措施[4-5]。目前,我国适龄女性乳腺癌筛查覆盖率整体仍处于较低水平,且存在明显的城乡与地域差异,筛查服务可及性与公平性有待提升[6]。现有乳腺癌筛查依从性的研究多聚焦于东部发达地区或全国性宏观调查[7-8],然而我国东、中、西部经济、医疗资源及健康素养差异显著[9-10]。中部地区乳腺癌高危人群筛查依从性现状及影响因素与东部地区存在潜在异质性,相关本地化系统性研究仍显匮乏。鉴于此,本研究选取南昌市城市乳腺癌高危人群为研究对象,分析其筛查依从性现状,并从个体特征、生活习惯等多维度探讨影响因素,为优化南昌市乳腺癌筛查策略、提升高危人群筛查参与率提供科学依据。
本研究对象来源于2021—2023年南昌市城市癌症早诊早治项目筛查人群,综合考虑高危人群检出率和临床筛查参与率,确定研究人数。所有研究对象均已完成乳腺癌危险因素问卷调查及高危风险评估,并被评估为乳腺癌高危人群。纳入标准:(1)南昌市常住户籍人口;(2)年龄45~74岁(以身份证信息为准);(3)经国家癌症防控信息管理平台风险评估系统判定为乳腺癌高危人群;(4)自愿签署知情同意书。本研究已获得中国医学科学院肿瘤医院伦理委员会审查批准(批号:CH-PRE-004)。
采取多阶段整群随机抽样方法,以南昌市城区所有街道为初级抽样单位,社区为次级单位,按人口规模比例随机抽取,每个街道随机抽取3~5个社区,约覆盖社区总数的40%。选定社区人群,经问卷调查完成乳腺癌相关风险因素收集后,将数据录入“国家癌症防控信息管理平台”,系统自动评估乳腺癌高危人群。评估出的高危人群被推荐至江西省肿瘤医院,接受乳腺超声联合乳腺X线摄片的临床筛查。
乳腺癌筛查参与率(%)=实际参加筛查人数/评估确定的乳腺癌高危人数×100%,参与率越高,乳腺癌高危人群筛查依从性越好。纳入分析的因素包括年龄、民族、筛查年度、身体质量指数(body mass index,BMI)、文化程度、婚姻史、吸烟史(定义为每日吸烟至少1支,且持续或累计时间≥6个月)、二手烟暴露史、饮酒史、体育锻炼(指平均每周≥3次,每次持续>30 min)、初潮年龄、绝经状态、生育史(含自然分娩与剖宫产)、哺乳史、良性乳腺疾病史(如乳腺增生、结节、导管扩张、良性纤维腺瘤、感染等)、血缘亲属乳腺癌史与血缘亲属卵巢癌史。
项目执行全过程严格遵循国家统一质控方案。所有调查员与医务人员均需培训考核合格后方可上岗。问卷调查采用调查员面对面询问或督导指导下完成,确保数据质量。问卷当日审核率达100%。数据采用身份证读卡器电子录入,并由质控员逐级核查,确保录入错误率低于5%。所有临床检查操作与结果判读均由指定医院具备相应资质的医师执行。
采用SPSS 25.0软件进行数据分析。计数资料以例数和百分比表示。运用χ2检验比较不同特征人群乳腺癌筛查参与率的差异,多因素logistic逐步回归模型分析筛查参与率的影响因素,计算优势比及其95%置信区间。检验水准α=0.05。
2021—2023年南昌市共完成19 980例乳腺癌高危评估问卷调查,评估为乳腺癌高危者9 138例,平均年龄为(57.83±7.98)岁。在9 138例乳腺癌高危人群中,共有4 228例接受了乳腺癌的筛查,筛查参与率为46.27%。
乳腺癌筛查依从性与年龄、筛查年度、BMI、文化程度、婚姻状况、吸烟史、二手烟暴露史、饮酒史、体育锻炼、生育史、哺乳史、良性乳腺疾病史、血缘亲属乳腺癌史和血缘亲属卵巢癌史有关(P<0.05)。见表1。
以筛查依从性为因变量,以年龄、筛查年度、BMI、文化程度、婚姻状况、吸烟史、二手烟暴露史、饮酒史、体育锻炼、生育史、哺乳史、良性乳腺疾病史、血缘亲属乳腺癌史和血缘亲属卵巢癌史等为自变量进行二元logistic逐步回归分析,结果显示,文化程度高(OR=1.235,95%CI:1.052~1.450)、吸烟(OR=1.519,95% CI:1.296~1.779)、有二手烟暴露史(OR=1.784,95% CI:1.621~1.964)、有生育史(OR=2.631,95% CI:2.141~3.233)、有良性乳腺疾病史(OR=1.846,95% CI:1.683~2.025)以及有血缘亲属乳腺癌史(OR=1.560,95% CI:1.406~1.731)的高危人群是筛查参与的促进因素(P<0.05)。年龄在65~74岁(OR=0.572,95% CI:0.508~0.645)、筛查年份在2022年(OR=0.644,95% CI:0.573~0.724)及2023年(OR=0.709,95% CI:0.637~0.789)、每周进行体育锻炼≥3次(OR=0.763,95% CI:0.691~0.844)、有哺乳史(OR=0.882,95% CI:0.803~0.970)的高危人群是筛查参与的不利因素(P<0.05)。见表2。
本研究分析了2021—2023年南昌市城市乳腺癌高危人群的筛查依从性及其影响因素。高危人群的总体筛查参与率为46.27%,这一发现与我国其他非东部城市基本一致[11-12],凸显出将风险识别转化为有效干预行动仍是公共卫生实践中的核心挑战。本研究筛查参与率显著低于东部发达地区(高危人群筛查参与率为53.48%)[13],这可能与东部地区有更完善的筛查网络与健康传播,提升了服务可及性与风险认知有关。
本研究显示,具有吸烟史、二手烟暴露史、生育史、良性乳腺疾病史及乳腺癌家族史的人群,其是筛查参与率的促进因素。这可能与上述人群对自身风险认知更明确、健康警觉性较强有关,符合健康信念模型的理论框架[14-15]。同时,文化程度较高者筛查意愿更强,反映健康素养在促进筛查行为中的重要作用[16]。相比45~54岁人群,65~74岁是筛查参与率的不利因素,可能与老年人行动受限、信息获取渠道窄、对筛查认知不足有关。相较2021年,2022和2023年是筛查参与率的不利因素,提示新冠疫情对常规筛查服务持续产生干扰。有哺乳史及每周锻炼≥3次的人群是筛查率的不利因素,这与马艳玲等[17]研究结果一致。前者可能因过高估计哺乳的保护作用[18]而忽视风险,后者则可能因对自身生活方式过于自信而降低筛查意愿[19]。值得关注的是,这一“健康自信盲区”在东部地区同类研究中较少被强调,可能因其居民整体健康素养较高,上述认知偏差被更普遍的筛查意识所抵消。这提示中部地区在健康促进中,需重点关注此类因认知偏差而筛查意愿偏低的人群,将其作为今后健康教育的重点。
基于以上发现,建议从以下三方面改进筛查工作:一是开展针对性宣传教育,重点面向高龄、有哺乳史及经常锻炼但筛查意愿低的群体,纠正其对乳腺癌风险的认知偏差;二是优化筛查服务模式,通过社区组织、移动筛查等方式提升可及性,并在公共卫生事件后加强服务恢复与宣传;三是在临床诊疗中强化机会性筛查,特别是对已有良性乳腺疾病或家族史的就诊者,应及时进行风险评估与筛查引导。
本研究存在一定局限:横断面设计仅能揭示变量间的关联,难以推断因果关系,受原始问卷限制,未能纳入雌激素使用史、医疗可及性、区域经济水平等潜在影响因素,且研究对象来源于自愿参与筛查项目的人群,可能存在“健康志愿者偏移”后续研究可进一步拓展。
综上,南昌市乳腺癌高危人群筛查参与率受多因素综合影响,需采取差异化、多渠道的干预策略,逐步提升筛查覆盖率,以实现乳腺癌早诊早治的防控目标。
  • 江西省中医药管理局科技计划项目(2025022430)
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2026年第53卷第11期
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doi: 10.20043/j.cnki.MPM.202601299
  • 接收时间:2026-01-20
  • 首发时间:2026-11-02
  • 出版时间:2026-06-10
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  • 收稿日期:2026-01-20
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江西省中医药管理局科技计划项目(2025022430)
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    1.传染病预防控制国家重点实验室研究基地、江西省动物源与媒介生物性传染病重点实验室、南昌市疾病预防控制中心,江西 南昌 330038
    2.江西省肿瘤医院

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2种不同金属材料的力学参数
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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