Department of General Practice.
Normandie University, Unicaen, Inserm, Anticipe, Caen.
Eur J Cancer Prev. 2020 Sep;29(5):458-465. doi: 10.1097/CEJ.0000000000000557.
Some of the inequality in uterine cervical cancer (UCC) screening uptake are due to the socioeconomic deprivation of women. A national organized screening programme has proven to be effective in increasing the uptake, but may increase socioeconomic inequality. Therefore, we compared inequality in uptake of UCC screening between two French departments, one of which is experimenting an organized screening programme. We used reimbursement data from the main French health insurance scheme to compare screening rates in the municipalities of the two departments over a three-year period. The experimental department had higher screening rates, but the increase in deprivation in municipalities had a greater effect on the decrease in participation in this department. Moreover, while screening rates were higher in urban areas, the negative effect of deprivation on participation was greater in rural areas. Although these departments were compared at the same time under different conditions, socioeconomic inequality between them may have been greater before the experimentation started. However, screening may have led to an increase in socioeconomic inequality between women screened. Special attention must be paid to changes in socioeconomic and geographic inequality in the uptake of UCC screening when the programme is rolled out nationally.
一些子宫颈癌（UCC）筛查参与度的不平等是由于妇女的社会经济贫困造成的。国家组织的筛查计划已被证明可有效提高参与度，但可能会增加社会经济不平等。因此，我们比较了法国两个省份之间 UCC 筛查参与度的不平等，其中一个省份正在试行组织筛查计划。我们使用主要法国健康保险计划的报销数据，在三年内比较了这两个省份的市政当局的筛查率。试验部门的筛查率较高，但在贫困程度较高的城市，参与率的下降对该部门的影响更大。此外，虽然城市地区的筛查率较高，但贫困对参与的负面影响在农村地区更大。尽管这两个部门在不同的条件下同时进行了比较，但在试行之前，它们之间的社会经济不平等可能更大。然而，筛查可能导致已筛查妇女之间的社会经济不平等程度增加。在全国范围内推出该计划时，必须特别关注 UCC 筛查参与度的社会经济和地理不平等的变化。
