Socioeconomic determinants of vaccination and cervical cancer screening via Pap smear. Analysis of the Health and Social Protection Survey (ESPS), 2012

Vaccination coverage rates for the adult diphtheria, tetanus, and polio (DTP) booster and for human papillomavirus (HPV) vaccination among adolescent girls are insufficient in France. The French Institute for Public Health Surveillance (InVS) analyzed data from the 2012 Health and Social Protection Survey (ESPS) to explore the socioeconomic determinants of these vaccinations, as well as those of cervical cancer screening via Pap smears. The survey focused on a representative random sample of Health Insurance beneficiaries. Information was collected via telephone interviews and self-administered questionnaires. Poisson regressions were used to analyze the association between explanatory variables and vaccination/screening. DTP vaccination coverage was insufficient (50%), and the factors associated with this coverage were similar to those obtained in the 2002 ESPS survey. HPV vaccination coverage was generally very insufficient (31% for 3 doses). Cervical smear screening coverage was 72% over 3 years. Low household income and the absence of private supplemental health insurance were associated with lower HPV vaccination rates and less frequent use of screening. The absence of FCU screening in the mother was associated with lower HPV vaccination rates in the daughter. Girls who have not been vaccinated against HPV tend to belong to the lowest socioeconomic categories and are more likely to have mothers who have not been screened. These girls are at risk of not benefiting from either of the two cervical cancer prevention measures, suggesting a limited impact of the vaccination program. The current implementation of HPV vaccination thus risks widening social health inequalities regarding cervical cancer.

Author(s): Guthmann JP, Pelat C, Parent du Chatelet I, Duport N, Levy Bruhl D, Rochereau T, Celant N

Publishing year: 2016

Pages: 48 p.

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