Background Breast cancer is the most prevalent malignancy affecting Chinese women, and early routine screening is incredibly important for its prevention and control. This study aimed to investigate the role of socioeconomic status (SES) in female breast cancer screening practices using the composite SES index. Methods This cross-sectional study involved 1816 women in Eastern China. Data were collected using an online self-administered questionnaire from January 2020 to May 2021. We used principal component analysis to construct the composite SES index using educational level, annual household income, and occupation. Logistic regression was used to analyze the association between the SES index and breast cancer screening utilization. Results Of the participants, 19.27% reported having performed breast self-examination, 12.89% reported having undergone clinical breast examination, and 3.52% reported having received mammography. The SES has a significant influence on the patronage of female breast cancer screening in Eastern China. The composite SES index was found to have a positive and significant association with breast cancer screening practices. An interaction was found between the SES index and patient characteristics, such as health awareness, marital status, and location of residence. In addition, the SES index had a positive effect on breast cancer-related knowledge. Conclusions Socioeconomic inequalities existed in Eastern China and were related to breast cancer screening patronage. The composite SES index was identified as a significant determinant of breast cancer screening practices. Our results highlighted the negative impacts of socioeconomic inequities on female breast cancer screening utilization. This suggests that reducing socioeconomic inequalities in breast cancer screening requires more focused interventions and concerted outreach activities for groups with lower education levels, lower income, or lower occupational classes.
Background This study aimed to establish a structural equation model to determine the associations among knowledge of breast cancer, beliefs about breast self-examination (BSE), BSE practice, socio-economic status (SES), and barriers to BSE among Eastern Chinese women. Methods An online cross-sectional correlational survey of 2026 women from Eastern China was undertaken by a self-administered questionnaire in 2020. Structural equation modeling was utilized for examining the interrelationships between BSE barriers and other variables. Results Our results suggested that BSE barriers were significantly and negatively related to SES, BSE beliefs, and BSE practices (β = -0.176, p < 0.001 and β = -0.118, p < 0.001 and β = -0.435, p < 0.001, respectively). Among them, participants’ BSE practices had the strongest effects on BSE barriers, while the effect of breast cancer knowledge on BSE barriers was in an opposite direction (β = 0.177, p < 0.001). Conclusions BSE barriers were influenced by SES, breast cancer knowledge, BSE beliefs and BSE practices. Our results warn that breast cancer prevention education should strengthen knowledge of practical methods rather than general knowledge. Therefore, intervention strategies designed to develop BSE and breast cancer prevention should take into account multiple factors, in particular finding more effective ways for the public to turn knowledge into a motivator rather than a barrier.
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