背景:印度的癌症负担一直在上升,然而,早期检测的测试仍然很低。这项研究探讨了印度女性在乳腺癌(BC)检查和宫颈癌(CC)摄取方面的不平等,关注社会经济,区域,教育差异。
方法:来自2019-21年全国家庭健康调查(n=353,518)的数据用于评估BC检查和CC测试的摄取。不等式使用不等式斜率指数(SII)进行量化,相对不平等指数(RII),和相对浓度指数(RCI)。SII测量了绝对不平等,而RII和RCI评估了弱势群体和优势群体之间的相对不平等。
结果:早期检测BC和CC的检测方法一直很低,为每1000名女性9和20,分别。与最贫穷的家庭相比,最富有家庭的妇女的摄取更高(SII:不列颠哥伦比亚省为1.1,CC为1.8)。与城市地区相比,农村地区的相对社会经济不平等程度更为明显(RCI:BC为22.5,CC为21.3)。同样,受过高等教育的女性接受BC检查和CC检测的可能性分别为4.84倍(RII:4.84)和2.12倍(RII:2.12),分别,与未受过教育的妇女相比。东北地区表现出更大的社会经济不平等,而西部地区表现出更多基于教育的不平等。
结论:BC检查和CC测试的较低使用率和明显的不平等现象突出表明,需要有针对性的干预措施来改善测试服务的获取和利用,尤其是在受教育程度较低的女性中,和农村地区的人。
BACKGROUND: The burden of cancer in India has been rising, yet testing for early detection remains low. This study explored inequalities in the uptake of breast cancer (BC) examination and cervical cancer (CC) among Indian women, focusing on socioeconomic, regional, and educational differences.
METHODS: Data from the 2019-21 National Family Health Survey (n=353,518) were used to assess the uptake of BC examination and CC testing. Inequalities were quantified using the slope index of inequality (SII), relative index of inequality (RII), and relative concentration index (RCI). SII measured absolute inequality, while RII and RCI assessed relative inequality between disadvantaged and advantaged groups.
RESULTS: The ever uptake of tests for early detection of BC and CC were low at 9 and 20 per 1,000 women, respectively. Higher uptake was observed among women from the richest households compared to the poorest (SII: 1.1 for BC and 1.8 for CC). The magnitude of relative socioeconomic inequalities was more pronounced in rural areas (RCI: 22.5 for BC and 21.3 for CC) compared to urban areas. Similarly, higher-educated women were 4.84 times (RII: 4.84) and 2.12 times (RII: 2.12) more likely to undergo BC examination and CC testing, respectively, compared to non-educated women. The northeastern region exhibited greater socioeconomic inequality, while the western region showed more education-based inequality.
CONCLUSIONS: The lower uptake of BC examination and CC testing and the marked inequalities underscore the need for targeted interventions to improve access and utilization of testing services, especially among lower-educated women, and those in rural areas.