Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah 80200, Saudi Arabia.
School of Commerce, Centre for Health, Informatics and Economic Research, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD 4350, Australia.
Int J Environ Res Public Health. 2020 Mar 20;17(6):2056. doi: 10.3390/ijerph17062056.
Timely and adequate screening for breast cancer could improve health outcomes and reduce health costs. However, the utilization of free breast cancer screening services among Saudi women is very low. This study aims to investigate socioeconomic inequalities in breast cancer screening among Saudi women. The data of this study were extracted from the nationally representative Saudi Health Interview Survey, conducted in 2013; the study included 2786 Saudi women. Multivariate logistic regression, the concentration curve, and the concentration index were used to examine, illustrate, and quantify income- and education-related inequalities in three outcomes: Knowledge about self-breast examination (SBE), clinical breast examination (CBE) received in the last year, and mammography, that has ever been previously carried out. Results showed a marked socioeconomic gradient in breast cancer screening services. The concentration index by income was 0.229 (SBE), 0.171 (CBE), and 0.163 (mammography). The concentration index by education was 0.292 (SBE), 0.149 (CBE), and 0.138 (mammography). Therefore, knowledge about breast cancer screening, and the utilization of screening services, were more concentrated among richer and better-educated women. Poorer and less educated women had less knowledge about self-breast examination, and had considerably less adherence to clinical breast examination and mammography. The findings are helpful for policy makers to devise and implement strategies to promote equity in breast cancer screening among Saudi women.
及时和充分的乳腺癌筛查可以改善健康结果并降低医疗成本。然而，沙特女性对免费乳腺癌筛查服务的利用率非常低。本研究旨在调查沙特女性乳腺癌筛查中的社会经济不平等问题。本研究的数据来自于 2013 年进行的全国代表性沙特健康访谈调查，共纳入了 2786 名沙特女性。采用多变量逻辑回归、集中曲线和集中指数，检验、说明和量化了收入和教育相关不平等对三个结果的影响：对自我乳房检查（SBE）的了解、去年接受的临床乳房检查（CBE）和以往进行过的乳房 X 光检查。结果显示，乳腺癌筛查服务存在明显的社会经济梯度。收入的集中指数分别为 0.229（SBE）、0.171（CBE）和 0.163（乳房 X 光检查）。教育的集中指数分别为 0.292（SBE）、0.149（CBE）和 0.138（乳房 X 光检查）。因此，乳腺癌筛查知识和筛查服务的利用更多地集中在较富裕和教育程度较高的女性中。较贫穷和教育程度较低的女性对自我乳房检查的了解较少，对临床乳房检查和乳房 X 光检查的依从性也明显较低。这些发现有助于政策制定者制定和实施策略，以促进沙特女性乳腺癌筛查的公平性。
