探讨上海市女性参加宫颈癌和乳腺癌筛查(以下简称为"两癌"筛查)意愿及其影响因素。

选择2025年1月至6月采用二阶段混合抽样方法在上海市16个区参加"两癌"筛查的779名女性为调查对象。对被调查对象采用本研究自行设计的《上海市妇女"两癌"筛查规范管理路径研究服务对象调查问卷》(以下简称为《调查问卷》)进行调查。该问卷主要包括参加"两癌"筛查调查对象的以下4个方面内容。①一般资料；②参加"两癌"筛查的基本情况；③对"两癌"防治知识知晓情况；④参加筛查意愿。根据《调查问卷》中参加筛查意愿得分，将被调查对象分别纳入低意愿组(n＝399，《调查问卷》中参加筛查意愿得分<4分者)与高意愿组(n＝380，《调查问卷》中参加筛查意愿得分≥4分者)。采用成组t检验或χ²检验，对2组被调查对象《调查问卷》结果进行统计学分析。对单因素分析中2组被调查对象比较差异有统计学意义的变量(P<0.05)，进一步采用多因素非条件logistic回归分析法，对影响被调查对象参加"两癌"筛查意愿的因素进行分析。本研究经过上海市妇幼保健中心医学伦理委员会审查批准(审批文号：2025-F003-001)，并与被调查对象均签署调查知情同意书。

①本研究共计发放《调查问卷》为800份，回收有效问卷为779份，有效问卷回收率为97.38%。②本研究779名被调查对象中，对"两癌"筛查服务的筛查项目、筛查流程、筛查环境和筛查人员态度满意度分别为99.36%(774/779)、99.74%(777/779)、99.23%(773/779)、99.36%(774/779)；97.56%(760/779)被调查对象认为有必要定期进行"两癌"筛查。影响被调查对象参加"两癌"筛查的因素主要为：本人健康需求(56.48%，440/779)，"两癌"筛查便捷程度(38.90%，303/779)和筛查费用(27.09%，211/779)。③低意愿组与高意愿组被调查对象的年龄、居住地点、就业情况、受教育程度、月经情况和家庭人均月收入等分别比较，差异均有统计学意义(P<0.05)。以参加"两癌"筛查意愿高、低作为因变量，以上述单因素分析结果中差异有统计学意义的变量作为自变量，进行非条件多因素logistic回归分析的结果显示，居住地远离主城区(OR＝0.652，95%CI：0.448~0.950，P＝0.026)，无业人员(OR＝0.418，95%CI：0.219~0.798，P＝0.008)，受教育程度为初中及以下(OR＝0.413，95%CI：0.261~0.655，P<0.001)，家庭人均月收入为2 000~4 999元(OR＝0.537，95%CI：0.321~0.897，P＝0.018)及<2 000元(OR＝0.397，95%CI：0.190~0.831，P＝0.014)的被调查对象的"两癌"筛查意愿较低。

无业、低收入、受教育程度低及居住地点远离主城区的上海市女性人群参加"两癌"筛查意愿较低，未来应当重点关注此类人群。

To explore the willingness of women in Shanghai to participate in cervical and breast cancer screening (hereinafter referred to as " Two-cancer screening" ) and its influencing factors.

From January to June 2025, a two-stage mixed sampling method was adopted to select 779 women participating in the " Two-cancer screening" across 16 districts of Shanghai as research subjects. A field questionnaire survey was conducted using the self-designed Questionnaire on Standardized Management Path of Cervical and Breast Cancer Screening in Shanghai for Service Recipients (hereinaffter referred to as " the Survey Questionnaire" ). The Survey Questionnaire mainly covered four dimensions: ①general information of respondents; ②basic status of respondents′ participation in " Two-cancer screening" ; ③awareness level of respondents regarding prevention and treatment knowledge of the " Two-cancer screening" ; ④respondents′ willingness to underwent " Two-cancer screening". Based on the total score of willingness to underwent " Two-cancer screening", the respondents were divided into low willingness group (n=399, total score of willingness to underwent " Two-cancer screening" < 4 points) and high willingness group (n=380, total score of willingness to underwent " Two-cancer screening" ≥ 4 points). Independent-samples t test or chi-square test was used for statistical comparison of the questionnaire survey results between two groups. Variables with statistically significant differences in univariate analysis (P<0.05) were further included in multivariate unconditional logistic regression analysis to identify the influencing factors of women′s willingness to participate in the " Two-cancer screening". This study was reviewed and approved by the Medical Ethics Committee of Shanghai Municipal Center for Women and Children′s Health (Approval No. 2025-F003-001), and informed consent for the survey were obtained from all participants.

①A total of 800 questionnaires were distributed, and 779 valid questionnaires were recovered, with an effective recovery rate of 97.38%. ②Among the 779 respondents in this study, the satisfaction rates with screening items, procedures, environment and staff attitude of the " Two-cancer screening" service were 99.36% (774/779), 99.74% (777/779), 99.23% (773/779), and 99.36% (774/779), respectively; 97.56% (760/779) of respondents considered regular " Two-cancer screening" necessary. The main factors influencing respondents′ participation in " Two-cancer screening" were: their own health needs (56.48%, 440/779), the convenience of " Two-cancer screening" (38.90%, 303/779), and the screening cost (27.09%, 211/779). ③There were statistically significant differences between the low willingness group and high willingness group in terms of age, residential location, employment status, educational level, menstrual status, and per capita monthly household income (all P<0.05). Taking the willingness to participate in " Two-cancer screening" as the dependent variable and the statistically significant variables in univariate analysis as independent variables, multivariate unconditional logistic regression analysis showed that respondents residing in outer suburban areas (OR=0.652, 95%CI: 0.448-0.950, P=0.026), unemployed individuals (OR=0.418, 95%CI: 0.219-0.798, P=0.008), those with junior high school education or below (OR=0.413, 95%CI: 0.261-0.655, P<0.001), and those with per capita monthly household income of 2 000-4 999 yuan (OR=0.537, 95%CI: 0.321-0.897, P=0.018) or less than 2 000 yuan (OR=0.397, 95%CI: 0.190-0.831, P=0.014) had lower willingness to participate in the screening.

Unemployed women, those with low income or low educational attainment, and residents of outer suburban districts exhibit lower willingness to participate in " Two-cancer screening". These groups should be given more attention in the future.