Ghent University, Gent, Oost-Vlaanderen, Belgium.
University of Geneva, Geneva, GE, Switzerland.
J Health Soc Behav. 2020 Sep;61(3):377-395. doi: 10.1177/0022146520938708. Epub 2020 Jul 19.
The current study examines whether the extent of macrolevel gender inequality affects the association between women's educational attainment and their participation in cervical and breast cancer screening and how this relationship is moderated by a country's cancer screening strategy (organized vs. opportunistic). A multilevel design with women (N = 99,794; N = 55,021) nested in 30 European countries was used to analyze data from the European Health Interview Survey (2013-2015). Results of multilevel logistic regression models demonstrate that higher macrolevel gender inequality is associated with (a) a lower overall likelihood that women have had a mammography and Pap smear and (b) a larger gap in participation between women with low and high levels of education, regardless of a country's screening strategy (i.e., no moderation by a country's screening strategy was found). We conclude that macrolevel gender stratification should not be neglected when designing cancer screening policy.
本研究考察了宏观性别不平等程度是否会影响女性受教育程度与宫颈癌和乳腺癌筛查参与之间的关联，以及这种关系是否受到国家癌症筛查策略（有组织与机会性）的调节。该研究采用多层次设计，将女性（N=99794；N=55021）嵌套在 30 个欧洲国家中，对欧洲健康访谈调查（2013-2015 年）的数据进行了分析。多水平逻辑回归模型的结果表明，较高的宏观性别不平等程度与以下情况相关：（a）女性进行乳房 X 光检查和巴氏涂片检查的总体可能性较低；（b）无论国家的筛查策略如何（即，未发现国家筛查策略的调节作用），教育程度较低和较高的女性之间的参与差距更大。我们的结论是，在制定癌症筛查政策时，不应忽视宏观性别分层。
