Menvielle Gwenn, Richard Jean-Baptiste, Ringa Virginie, Dray-Spira Rosemary, Beck François
INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 75013, Paris, France,
Cancer Causes Control. 2014 Aug;25(8):977-83. doi: 10.1007/s10552-014-0397-z. Epub 2014 May 20.
In France, larger social inequalities are reported for cervical cancer screening, based on individual practice, than for breast cancer screening for which organized screening exists. Our aim was to investigate the association between women's economic situation and breast and cervical cancer screening.
We used data from a large French national health survey conducted in 2010. The economic situation was assessed using the number of adverse economic conditions respondents were facing, based on three variables (low income, lacking food, and perceived financial difficulties). Logistic regressions were adjusted for socioeconomic and sociodemographic characteristics, healthcare use and insurance, and health behaviors.
Mammography was less frequent among women experiencing two or more adverse economic conditions, whereas Pap smear was less frequent among women experiencing at least one adverse economic condition. For both screenings, higher rates were observed among women who lived in the Paris region. Sociodemographic indicators and health behaviors were associated with Pap smear, whereas healthcare use and insurance characteristics were associated with mammography.
The women's economic situation is an important determinant of breast and cervical cancer screening in France in 2010. Alleviating economic barriers to female cancers screening should be a priority in future programs implementation.
在法国,据报告,基于个人行为的宫颈癌筛查的社会不平等现象比有组织筛查的乳腺癌筛查更为严重。我们的目的是调查女性经济状况与乳腺癌和宫颈癌筛查之间的关联。
我们使用了2010年法国一项大型全国性健康调查的数据。经济状况是根据受访者面临的不利经济状况数量来评估的,这基于三个变量(低收入、食物匮乏和感知到的经济困难)。逻辑回归针对社会经济和社会人口特征、医疗保健使用和保险以及健康行为进行了调整。
在经历两种或更多不利经济状况的女性中,乳房X光检查的频率较低,而在经历至少一种不利经济状况的女性中,巴氏涂片检查的频率较低。对于这两种筛查,居住在巴黎地区的女性的筛查率更高。社会人口指标和健康行为与巴氏涂片检查相关,而医疗保健使用和保险特征与乳房X光检查相关。
2010年在法国,女性的经济状况是乳腺癌和宫颈癌筛查的一个重要决定因素。在未来项目实施中,减轻女性癌症筛查的经济障碍应成为优先事项。