{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:20:57Z","timestamp":1791210057547,"version":"4.1.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Key Projects of Science Research in Colleges in Anhui Province, China","award":["SK2020A0348, SK2018A1074"],"award-info":[{"award-number":["SK2020A0348, SK2018A1074"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0279107","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T18:34:20Z","timestamp":1671042860000},"page":"e0279107","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["Socioeconomic status index is an independent determinant of breast cancer screening practices: Evidence from Eastern China"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3221-3628","authenticated-orcid":true,"given":"Shunhua","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hairuo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binhao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizheng","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"issue":"3","key":"pone.0279107.ref001","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin."},{"issue":"6","key":"pone.0279107.ref002","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.","volume":"68","author":"F Bray","year":"2018","journal-title":"CA Cancer J Clin."},{"issue":"7","key":"pone.0279107.ref003","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1002\/ijc.30825","article-title":"Cancer incidence and mortality: A cohort study in China, 2008\u20132013","volume":"141","author":"R Pan","year":"2017","journal-title":"Int J Cancer"},{"issue":"5","key":"pone.0279107.ref004","first-page":"466","article-title":"Female breast cancer statistics of 2010 in China: estimates based on data from 145 population-based cancer registries.","volume":"6","author":"H Zeng","year":"2014","journal-title":"J Thorac Dis."},{"issue":"7","key":"pone.0279107.ref005","first-page":"1221","article-title":"Female breast cancer incidence and mortality in 2011, China.","volume":"7","author":"M Jia","year":"2015","journal-title":"J Thorac Dis."},{"issue":"1","key":"pone.0279107.ref006","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/j.1759-7714.2012.00165.x","article-title":"Incidence and mortality of breast cancer in China, 2008.","volume":"4","author":"WQ Chen","year":"2013","journal-title":"Thorac Cancer."},{"issue":"4","key":"pone.0279107.ref007","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1111\/1759-7714.12037","article-title":"Incidence and mortality of female breast cancer in China, 2009.","volume":"4","author":"H Zeng","year":"2013","journal-title":"Thorac Cancer."},{"issue":"6","key":"pone.0279107.ref008","doi-asserted-by":"crossref","first-page":"438","DOI":"10.3322\/caac.21583","article-title":"Breast cancer statistics, 2019.","volume":"69","author":"CE DeSantis","year":"2019","journal-title":"CA Cancer J Clin."},{"issue":"9","key":"pone.0279107.ref009","doi-asserted-by":"crossref","first-page":"e1203","DOI":"10.1016\/S2214-109X(20)30261-8","article-title":"Breast cancer survival and survival gap apportionment in sub-Saharan Africa (ABC-DO): a prospective cohort study.","volume":"8","author":"V McCormack","year":"2020","journal-title":"Lancet Glob Health."},{"issue":"15","key":"pone.0279107.ref010","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1001\/jama.2015.12783","article-title":"Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society","volume":"314","author":"KC Oeffinger","year":"2015","journal-title":"JAMA"},{"issue":"2","key":"pone.0279107.ref011","doi-asserted-by":"crossref","DOI":"10.17061\/phrp2921911","article-title":"Improving breast cancer screening in Australia: a public health perspective.","volume":"29","author":"C Nickson","year":"2019","journal-title":"Public Health Res Pract"},{"key":"pone.0279107.ref012","doi-asserted-by":"crossref","first-page":"g366","DOI":"10.1136\/bmj.g366","article-title":"Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial","volume":"348","author":"AB Miller","year":"2014","journal-title":"BMJ"},{"issue":"7","key":"pone.0279107.ref013","doi-asserted-by":"crossref","first-page":"e279","DOI":"10.1016\/S1470-2045(13)70567-9","article-title":"Breast cancer in China.","volume":"15","author":"L Fan","year":"2014","journal-title":"Lancet Oncol"},{"issue":"1","key":"pone.0279107.ref014","first-page":"2","article-title":"Current status of breast cancer prevention in China.","volume":"1","author":"F Wang","year":"2015","journal-title":"Chronic Dis Transl Med"},{"issue":"5","key":"pone.0279107.ref015","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1111\/jog.13931","article-title":"Self-efficacy and its influencing factors of breast cancer screening for female college students in China","volume":"45","author":"T Xie","year":"2019","journal-title":"J Obstet Gynaecol Res"},{"issue":"2","key":"pone.0279107.ref016","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/jog.14550","article-title":"Structural equation modeling to detect predictors of breast self-examination behavior: Implications for intervention planning","volume":"47","author":"N Ju","year":"2021","journal-title":"J Obstet Gynaecol Res"},{"key":"pone.0279107.ref017","doi-asserted-by":"crossref","first-page":"E183","DOI":"10.5888\/pcd10.130136","article-title":"Breast cancer screening among adult women in China, 2010.","volume":"10","author":"B Wang","year":"2013","journal-title":"Prev Chronic Dis."},{"issue":"2","key":"pone.0279107.ref018","first-page":"208","article-title":"Study on the coverage of cervical and breast cancer screening among women aged 35\u201369 years and related impact of socioeconomic factors in China, 2013.","volume":"39","author":"HL Bao","year":"2018","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi."},{"issue":"1","key":"pone.0279107.ref019","doi-asserted-by":"crossref","first-page":"e005596","DOI":"10.1136\/bmjopen-2014-005596","article-title":"Do socioeconomic factors influence breast cancer screening practices among Arab women in Qatar?","volume":"5","author":"TT Donnelly","year":"2015","journal-title":"BMJ Open."},{"issue":"11","key":"pone.0279107.ref020","doi-asserted-by":"crossref","first-page":"e012753","DOI":"10.1136\/bmjopen-2016-012753","article-title":"Life-course socioeconomic status and breast and cervical cancer screening: analysis of the WHO\u2019s Study on Global Ageing and Adult Health (SAGE).","volume":"6","author":"T Akinyemiju","year":"2016","journal-title":"BMJ Open."},{"issue":"11","key":"pone.0279107.ref021","doi-asserted-by":"crossref","first-page":"e0225667","DOI":"10.1371\/journal.pone.0225667","article-title":"Socioeconomic determinants of cancer screening utilisation in Latin America: A systematic review","volume":"14","author":"B Nuche-Berenguer","year":"2019","journal-title":"PLoS One"},{"issue":"7\u20139","key":"pone.0279107.ref022","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1080\/07399332.2020.1814777","article-title":"Barriers to women\u2019s breast cancer screening behaviors in several countries: A meta-synthesis study","volume":"42","author":"I Ozkan","year":"2021","journal-title":"Health Care Women Int"},{"issue":"15","key":"pone.0279107.ref023","doi-asserted-by":"crossref","first-page":"6697","DOI":"10.7314\/APJCP.2015.16.15.6697","article-title":"Differences in Breast and Cervical Cancer Screening Rates in Jordan among Women from Different Socioeconomic Strata: Analysis of the 2012 Population-Based Household Survey.","volume":"16","author":"R Al Rifai","year":"2015","journal-title":"Asian Pac J Cancer Prev."},{"key":"pone.0279107.ref024","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1146\/annurev.publhealth.29.020907.090852","article-title":"U.S. disparities in health: descriptions, causes, and mechanisms","volume":"29","author":"NE Adler","year":"2008","journal-title":"Annu Rev Public Health"},{"key":"pone.0279107.ref025","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/1471-2407-12-122","article-title":"Breast cancer stage at diagnosis and area-based socioeconomic status: a multicenter 10-year retrospective clinical epidemiological study in China","volume":"12","author":"Q Wang","year":"2012","journal-title":"BMC Cancer"},{"key":"pone.0279107.ref026","first-page":"349","article-title":"Socioeconomic","volume":"36","author":"FC Pampel","year":"2010","journal-title":"Disparities in Health Behaviors"},{"issue":"6","key":"pone.0279107.ref027","first-page":"e0179272","volume":"12","author":"DC Wheeler","year":"2017","journal-title":"Estimating an area"},{"issue":"2","key":"pone.0279107.ref028","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1136\/jech.55.2.111","volume":"55","author":"KE Pickett","year":"2001","journal-title":"J Epidemiol Community Health"},{"issue":"1","key":"pone.0279107.ref029","first-page":"201","volume":"33","author":"AH Al-Zalabani","year":"2018","journal-title":"Breast Cancer Knowledge and Screening Practice and Barriers Among Women in Madinah"},{"issue":"1","key":"pone.0279107.ref030","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/NCC.0b013e31827f0a9d","article-title":"Breast cancer screening practices among Hong Kong Chinese women","volume":"37","author":"C Kwok","year":"2014","journal-title":"Cancer Nurs"},{"issue":"4","key":"pone.0279107.ref031","first-page":"576","volume":"68","author":"AA Naqvi","year":"2018","journal-title":"knowledge and attitude towards breast cancer"},{"issue":"5","key":"pone.0279107.ref032","first-page":"1919","volume":"15","author":"A Sreedevi","year":"2014","journal-title":"Screening for breast cancer in a low middle income country: predictors in a rural area of Kerala"},{"issue":"10","key":"pone.0279107.ref033","doi-asserted-by":"crossref","first-page":"e039464","DOI":"10.1136\/bmjopen-2020-039464","article-title":"Prevalence and determinants of breast cancer screening in four sub-Saharan African countries: a population-based study","volume":"10","author":"DM Ba","year":"2020","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0279107.ref034","first-page":"308","article-title":"Sample Size Determination In Health Research.","volume":"30","author":"W Sami","year":"2018","journal-title":"J Ayub Med Coll Abbottabad."},{"issue":"12","key":"pone.0279107.ref035","doi-asserted-by":"crossref","first-page":"4440","DOI":"10.1111\/jog.15064","article-title":"Relationship between demographic factors, health education, breast cancer-related knowledge, attitudes, and breast self-examination behavior among Chinese female college student: A structural equation analysis","volume":"47","author":"S Zhang","year":"2021","journal-title":"J Obstet Gynaecol Res"},{"issue":"5","key":"pone.0279107.ref036","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/sjop.12750","article-title":"Family socioeconomic status and Chinese high school students\u2019 test anxiety: Serial mediating role of parental psychological control, learning resources, and student academic self-efficacy.","volume":"62","author":"X Xu","year":"2021","journal-title":"Scand J Psychol"},{"issue":"1","key":"pone.0279107.ref037","first-page":"30","article-title":"The relationships among family SES, intelligence, intrinsic motivation and creativity.","volume":"23","author":"SJ Shi B","year":"2007","journal-title":"Psychol Dev Educ"},{"key":"pone.0279107.ref038","doi-asserted-by":"crossref","first-page":"2578","DOI":"10.3389\/fpsyg.2018.02578","article-title":"General Self-Efficacy Mediates the Effect of Family Socioeconomic Status on Critical Thinking in Chinese Medical Students.","volume":"9","author":"L Huang","year":"2018","journal-title":"Front Psychol."},{"key":"pone.0279107.ref039","doi-asserted-by":"crossref","first-page":"438","DOI":"10.3389\/fpsyg.2020.00438","article-title":"Hope and Creative Self-Efficacy as Sequential Mediators in the Relationship Between Family Socioeconomic Status and Creativity.","volume":"11","author":"Y Yang","year":"2020","journal-title":"Front Psychol."},{"key":"pone.0279107.ref040","doi-asserted-by":"crossref","first-page":"622941","DOI":"10.3389\/fpubh.2020.622941","article-title":"Association of Socioeconomic Status and Overweight\/Obesity in Rural-to-Urban Migrants: Different Effects by Age at Arrival.","volume":"8","author":"Y Wang","year":"2020","journal-title":"Front Public Health."},{"issue":"2","key":"pone.0279107.ref041","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1007\/s10995-015-1837-4","article-title":"Measures of Maternal Socioeconomic Status in Yemen and Association with Maternal and Child Health Outcomes.","volume":"20","author":"AN Alosaimi","year":"2016","journal-title":"Matern Child Health J."},{"key":"pone.0279107.ref042","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/1471-2458-12-99","article-title":"Socioeconomic disparities in the uptake of breast and cervical cancer screening in Italy: a cross sectional study","volume":"12","author":"G Damiani","year":"2012","journal-title":"BMC Public Health"},{"issue":"3","key":"pone.0279107.ref043","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1097\/CEJ.0b013e3282b6fde5","article-title":"Are breast cancer screening practices associated with sociodemographic status and healthcare access? Analysis of a French cross-sectional study","volume":"17","author":"N Duport","year":"2008","journal-title":"Eur J Cancer Prev"},{"issue":"1","key":"pone.0279107.ref044","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.ypmed.2004.11.016","article-title":"Who has regular mammograms? Effects of knowledge, beliefs, socioeconomic status, and health-related factors","volume":"41","author":"H Achat","year":"2005","journal-title":"Prev Med."},{"issue":"4","key":"pone.0279107.ref045","first-page":"618","article-title":"Socioeconomic factors association with knowledge and practice of breast self-examination among Iranian women","volume":"8","author":"P Yavari","year":"2007","journal-title":"Asian Pac J Cancer Prev"},{"issue":"1","key":"pone.0279107.ref046","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ypmed.2003.12.032","article-title":"Prevalence and correlates of repeat mammography among women aged 55\u201379 in the Year 2000 National Health Interview Survey.","volume":"39","author":"W Rakowski","year":"2004","journal-title":"Prev Med."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0279107","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T18:34:47Z","timestamp":1671042887000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0279107"}},"subtitle":[],"editor":[{"given":"Erin J. A.","family":"Bowles","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":46,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,14]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0279107","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,14]]}}}