Screening Results And Awareness Of Cervical Cancer Screening And HPV Vaccine Among Women From The Cervical Cancer Screening Program In Ordos,Inner Mongolia

Objective:Describing the distribution of human papillomavirus(HPV)infection and cervical cancer in Ordos City,analyzing the risk factors for HPV infection,cervical cancer and precancerous lesions,investigating the awareness of local women on cervical cancer screening and HPV vaccine,and exploring the factors that may affect the level of cognition,so as to provide guidance for the comprehensive prevention and control of cervical cancer in Ordos City,and provide data reference for other ethnic minority areas.Methods:1.HPV infection rate,cervical precancerous lesion and cervical cancer detection rate and risk factors of HPV infection:187863 women aged 35-64 with HPV results who participated in the cervical cancer screening program in Ordos City from 2016 to 2020 were included.The rank-sum ratio(RSR)was used to evaluate the burden of HPV infection and cervical cancer and precancerous lesions in different regions of Ordos City.The χ2 test was used to compare the distribution between ethnic groups,and the linear trend χ2 test was used to analyze the changes with screening year and age groups.The χ2 test and multivariate logistic regression were used to analyze the risk factors of HPV infection.2.A case-control study of risk factors for cervical cancer and precancerous lesions:A total of 781 women with CIN2+were selected among HPV-positive women,and the control was selected 1:1 from the women who participated in screening in the same flag area in the same year who were not diagnosed with CIN 2+,with an age difference of no more than 2 years.Univariate and multivariate conditions logistic regression were used to analyze Influencing factors.3.Cervical cancer screening and HPV vaccine awareness survey:A questionnaire survey was conducted on Han and Mongolian women who participated in cervical cancer screening in Ordos from 2016 to 2020,and information on their basic personal characteristics,history of reproductive tract diseases and family history of tumors,cognition of cervical cancer screening,and knowledge and acceptance of HPV vaccine.Results:1.A total of 187,863 women with HPV results in Ordos City from 2016 to 2020 were included,and the HPV positive detection rate was 12.81%,which was statistically significant between different regions,Otok Banner has the highest burden of HPV infection,and the HPV infection rate decreased with the increase of years(linear trendχ2=42.00,P<0.001),and increased with age(linear trend χ2=155.787,P<0.001).Ethnic minority(OR=1.278,95%CI:1.215-1.345),other marital status(OR=1.595,95%CI:1.431-1.779),menopausal(OR=1.313,95%CI:1.252-1.378),two or more pregnancies(OR=1.049,95%CI:1.018-1.080)and the age of first sexual intercourse is younger than 23 years(OR=1.151,95%CI:1.115-1.188)are risk factors for HPV infection.Farmers and herdsmen,have 1 sex partner and use condoms for contraception are protective factors.2.The detection rate of cervical precancerous lesions was 401.36/100,000,the detection rate of cervical cancer was 37.79/100,000,and the early diagnosis rate was 93.45%.The detection rate of cervical cancer and precancerous lesions varied among the regions.The detection rate of cervical cancer showed an increasing trend with age,reaching the highest in the 60-64 age group(linear trend χ2=17.53,P<0.001),and the detection rate of cervical precancerous lesions decreased with age,and it was highest in the 40-44 age group(linear trend χ2=35.81,P<0.001).The detection rates of cervical precancerous lesions and cervical cancer in ethnic minority women were higher than those in Han women(χ2=6.416,P=0.011).Knowing cervical cancer screening was a protective factor for cervical cancer and precancerous lesions(OR=0.695,95%CI:0.531-0.91 1).3.The awareness rates of cervical cancer screening among Han and Mongolian women were 49.62%and 54.29%,the awareness rates of HPV vaccine were 15.40%and 12.74%,respectively,and the willingness of women to vaccinate their children with HPV vaccine was 34.85%Han and 43.32%Mongolian,respectively(P<0.001).Among Han and Mongolian women,the top three ways to obtain cervical cancer screening information are through family or friend introductions,media and social welfare publicity.Among Han women,screening year,age,education level,marital status,occupation,history of reproductive tract diseases,family history of cancer,and knowing of HPV were the influencing factors of HPV vaccine awareness rate.Among mongolian women,screening year,region,education level,family history of cancer,and knowing of HPV were the influencing factors of HPV vaccine awareness rate.Women who knew about HPV vaccine were much more willing(85.03%)to vaccinate their children(26.59%)than those who did not know(x2=35 8 25.576,P<0.001).Conclusions:1.The HPV infection rate of women in Ordos City was 12.81%,and the HPV infection rate increased with age.Marital status,number of pregnancies,age of first sexual intercourse,number of sexual partners,and contraceptive methods are all important factors affecting HPV infection.It suggests that the screening of elderly women in ethnic minority areas should be strengthened,reproductive health education and consultation should be actively carried out,women’s awareness of HPV infection should be improved,and women should be encouraged to avoid controllable risk factors,so as to reduce the incidence of HPV infection in this area.2.The peak age of cervical precancerous lesions and cervical cancer detection rates is 60-64 years old and 40-44 years old,respectively,and there are ethnic and regional differences in the detection rates of cervical precancerous lesions and cervical cancer.It is suggested that future work should focus on screening management of different age groups,strengthen the prevention and control of ethnic minorities and areas with high cervical cancer incidence,achieve the purpose of early diagnosis and treatment,and reduce the occurrence of cervical cancer.3.Han and Mongolian women in Ordos have low awareness of cervical cancer screening and awareness and acceptance of HPV vaccine.Health education should be carried out through multiple channels,especially in rural areas,ethnic minorities,older age groups and women with low educational attainment,to raise awareness of cervical cancer screening and HPV vaccination.