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      The Practice and Willingness of Women Towards Opportunistic Screening for Breast and Cervical Cancers in Sichuan Province, China: A Cross-Sectional Study

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          Abstract

          Purpose

          To understand the practices and willingness of Chinese women to undergo opportunistic screening for breast cancer (BC) and cervical cancer (CC).

          Patients and Methods

          From July to August 2021, a cross-sectional study of 1446 women from six cities in Sichuan Province, China, was conducted. A questionnaire was used to investigate practices, willingness, and barriers to opportunistic screening for BC and CC. Furthermore, potential factors for opportunistic screening willingness were analyzed using the chi-squared test and logistic regression.

          Results

          During their lifetime, 312 (21.6%) and 388 (26.8%) women had undergone opportunistic screening for BC and CC, respectively. There were 1069 (73.9%) women willing to accept physician-recommended screening during a medical visit, while 835 (57.7%) were willing to have a voluntary screening at a healthcare institution. The main barriers to reluctance to participate in physician-recommended and voluntary screenings were “no symptoms; hence, no need for screening” and “unwillingness or difficulty in paying screening cost”. Ethnic minorities, lower education levels, and menopause were inversely associated, whereas awareness of the screening methods and eligibility for screening were positively associated with physician-recommended and voluntary screenings ( P < 0.05). Furthermore, awareness of “two-cancers” screening was positively associated with physician-recommended screening ( P < 0.05).

          Conclusion

          BC and CC opportunistic screening rates in Sichuan Province were low. The willingness to undergo physician-recommended screening was high, while that towards individual initiative screening was low. Public health education should be strengthened to increase cancer prevention awareness and knowledge of cancer screening, especially for women with low education, ethnic minorities, and post-menopause, for whom tailored interventions are suggested. In addition, novel ways of sharing screening costs need to be explored.

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          Most cited references36

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement.

            Update of the 2009 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for breast cancer.
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              Is Open Access

              What can we learn from China’s health system reform?

              Qingyue Meng and colleagues assess what China’s health system reform has achieved and what needs to be done over the next decade
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                Author and article information

                Journal
                Risk Manag Healthc Policy
                Risk Manag Healthc Policy
                rmhp
                Risk Management and Healthcare Policy
                Dove
                1179-1594
                07 February 2023
                2023
                : 16
                : 169-183
                Affiliations
                [1 ]School of Public Health, Southwest Medical University , Luzhou, Sichuan, People’s Republic of China
                [2 ]Department of Breast Surgery, Affiliated Hospital of Southwest Medical University , Luzhou, Sichuan, People’s Republic of China
                [3 ]School of Basic Medical Science, Southwest Medical University , Luzhou, Sichuan, People’s Republic of China
                Author notes
                Correspondence: Yunli Ye, Southwest Medical University , No. 1 Section 1, Xianglin Road, Longmatan District, Luzhou, Sichuan, People’s Republic of China, Tel/Fax +86 0813 3161797, Email yunliye072@swmu.edu.cn
                Author information
                http://orcid.org/0000-0002-3499-781X
                Article
                391534
                10.2147/RMHP.S391534
                9921511
                36785645
                5de99c44-0382-43ac-8a0f-47dfca8f0274
                © 2023 Li et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 28 September 2022
                : 20 January 2023
                Page count
                Figures: 4, Tables: 4, References: 39, Pages: 15
                Funding
                Funded by: Primary Health Development Research Center of Sichuan Province Program;
                This study was supported by the Primary Health Development Research Center of Sichuan Province Program (SWFZ18-Q-2).
                Categories
                Original Research

                Social policy & Welfare
                physician-recommended screening,voluntary screening,“two-cancers” screening,behavior,willingness

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