| Objective:To study the burden of cervical cancer on women in Shanxi Province.Aiming at the primary prevention measure for cervical cancer-HPV vaccination,study the current status of HPV vaccination in Shanxi Province and residents' awareness of HPV vaccine,and identify potential obstacles to future HPV vaccine promotion.Improve three level prevention system for cervical cancer and provide a reference for reducing the incidence of cervical cancer.Methods:Collecting the discharge information of sample institutions(75 hospitals and 70 community health service center from four cities in Shanxi Province)in 2015-2016.Using the three-digit ICD-10 category code to encode the inpatient diagnostic information.Establishing a database of cervical cancer discharged patients by Stata12.0 to analyze and compare.Going to the HPV vaccination site and use a semi-structured interview to ask the relevant person in charge to truly understand the HPV vaccination work since 2017,what are the problems and the next work plan.A multi-stage random sampling and convenient sampling method was used to go to some hospitals and communities in Taiyuan to conduct a questionnaire survey on high school students and above,and the public under 65 years old.A total of 1120 questionnaires were distributed and 1045 valid questionnaires were recovered.The effective recovery rate was 93.3%.The Student's t test and Analysis of Variance were used to compare the differences in cognitive scores of different characteristic groups,Multivariate linear regression was used to analyze the multi-factors that affected cognition,Chi-square test was used to compare the difference of HPV vaccine vaccination willingness of different characteristics groups,and hierarchical logistic regression analysis was used to deeply dig the public's HPV vaccine vaccination willingness and its influencing factors from multiple levels.The difference was statistically significant(P< 0.05).Results:The incidence of malignant tumors in Shanxi Province in 2013 was 226.28/100,000,which was lower than the national incidence(270.59/100,000).However,the successful bid rate of cervical cancer was 20.58/100,000,which is twice t he national rate.In addition,the mortality rate(4.53/100,000)is 1.73 times the national average mortality rate of cervical cancer.The proportion of patients with cervical cancer discharged from women in 2015-2016(25.25%)was also much higher than that of the National Cancer Registry's 2015 cervical cancer accounted for 6.24% of the number of women with cancer registration.The minimum age of cervical cancer discharged patients is 16 years old,and the highest age is 92 years old,reaching the highest proportion in the range of 46 to 55 years old;the average length of hospitalization is 21 days,and the average hospitalization burden is 23,893.73 yuan,which is much higher than the average economic burden of discharged patients in the province(10046.61yuan).HPV vaccination as a primary prevention method for cervical cancer has also encountered obstacles,that is,the serious imbalance between supply and demand of vaccines.In addition,because this vaccine is a second type of vaccine that needs to be voluntarily vaccinated at its own expense,Shanxi Provincial Center for Disease Control and Prevention and other vaccination sites were restricted by relevant regulations and did not specifically issue recommendations or publicity for such vaccines,this led to a low awareness of HPV and its vaccines by most residents in Taiyuan City.Only 36.56% of the respondents knew that HPV vaccination had been carried out in Shanxi.Less than 50% of people know that it is best to get HPV vaccine before sexual intercourse,only 39.71% know that men will also get HPV.The three questions with the lowest accura cy were: HPV can be transmitted through skin contact(9.95%),HPV can cause oral cancer(17.80%),and HPV can cause anal cancer(23.06%).Although the awareness is low,everyone is more positive about the HPV vaccination.76.75% of the respondents are will ing to receive the HPV vaccine at their own expense,and more than 80% of the respondents are willing to vaccinate the offspring.The reasons for not wanting to get the HPV vaccine mainly include not knowing the HPV vaccine(62.14%),worrying about safety/effectiveness(54.32%),the vaccine price is too high(40.74%),the son is not at risk(29.61%),doctor no recommendation(21.74%)and the child did not have sex so no vaccination was required(21.74%).95.31% of the respondents are willing to learn more about the HPV vaccine in the future.The preferred methods are health guidance and recommendations by doctors and other professionals(75.98%),and online media such as WeChat and Weibo(56.36%),Traditional media such as TV or radio or newspapers(51.1%).The univariate analysis results showed that the differences in cognitive scores among respondents of different ages,genders,long-term residences,education levels,medical related education,average monthly income,hearing and HPV vaccination were statistically significant(P<0.05).The results of multiple linear regression analysis showed that the cognitive scores of 36-55 years old were more significant(P<0.05),women and higher education also have a significant impact on cognitive scores(P<0.05).At the same time,they have received medical-related education,heard and vaccinated with HPV vaccine,and have a greater impact on cognition(P<0.001).The results of hierarchical logistic regression analysis showed that the population of childbearing age had a stronger willingness to vaccinate against HPV vaccine than the population under 18 years old(OR=2.996,P<0.001),female(OR=1.475,P<0.001),high school and college education(OR=2.01,P<0.05),had sexual intercourse(OR=2.008,P<0.01),heard of HPV vaccine(OR=1.942,P<0.001),knowing that men can also be infected with HPV(OR=1.693,P<0.001),knowing that HPV can cause anal cancer(OR=1.405,P<0.05),are all contributing factors for willingness to receive HPV vaccine.Conclusions:1.The incidence of cervical cancer and the proportion of cervical cancer in female malignant tumors in Shanxi Province are higher than the national average.The cost of hospitalization for cervical cancer per capita is higher than the economic burden of patients discharged from the province.2.Since the HPV vaccine was inoculated in Shanxi Province,the vaccine supply has been inadequate,publicity and health education have been inadequate,and residents have low awareness of HPV.Cervical cancer primary prevention measures are inadequate.3.The potential recipient population has a low level of knowledge about HPV vaccines,but has a high willingness to vaccinate.Health education and publicity guidance should be targeted.In order to reduce or even eliminate public cogni tive barriers to HPV vaccination and increase the HPV vaccination rate of people of right age and strengthen the primary prevention of cervical cancer. |
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