Cancer Screening for Women in France in 2010: Have Social Inequalities Disappeared for Breast Cancer?

Background.—The objective of this study is to characterize social differences in the uptake of breast and cervical cancer screening in France. In particular, the study aims to determine whether the near absence of social inequalities observed in mammography uptake in recent years persists when a precise measure of financial status is taken into account. Methods.—Using data from the 2010 Health Barometer, factors associated with screening were analyzed using logistic models. Various sociodemographic, socioeconomic, healthcare utilization, and health behavior factors were taken into account. A financial vulnerability score was constructed based on four variables (low income, foregoing care for financial reasons, not eating enough, and perceived financial difficulty). The higher the score, the more financial difficulties the woman faces. Results.- Financial vulnerability is strongly associated with screening practices: mammography is less frequent among women with the highest financial vulnerability score (OR for score ≥ 2/score = 0 = 1.75 (1.17–2.63)) and Pap smears are less frequent among women with a positive score, with no difference based on the score value (OR for score ≥ 2/score = 0 = 1.56 (1.06–2.29)). The other factor common to both screening methods is living in the Paris metropolitan area. Various social indicators and risky health behaviors are also associated with lower Pap smear rates. Conversely, the other factors associated with mammography use are the absence of private supplemental health insurance and no gynecological follow-up in the past year. Conclusion.—Organized breast cancer screening has largely reduced inequalities in access, with very few factors associated with mammography compared to Pap smears. However, financial considerations remain significant, and marked social inequalities in breast cancer screening persist. Source: poster cited in the "Revue d'épidémiologie et de santé publique" in Supplement 4, Issue 61.

ADELF-SFSP International Conference on "Public Health and Prevention", Bordeaux, 17-19 octobre 2013

Author(s): Menvielle G, Richard J.B, Ringa V, Dray-spira R, Beck F

Publishing year: 2013

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