Are breast cancer screening practices associated with sociodemographic status and healthcare access? Analysis of a French cross-sectional study

Eur J Cancer Prev. 2008 Jun;17(3):218-24. doi: 10.1097/CEJ.0b013e3282b6fde5.

Abstract

The aim of this study was to analyse the role of women's sociodemographic and healthcare access characteristics according to breast cancer screening practices (organized, individual or no screening). A cross-sectional study was set up in seven French districts using a self-administered postal questionnaire. Randomization was stratified proportionally on age and urban/rural status in each district separately among attendees and nonattendees to the organized breast cancer screening programme (OS). A total of 5638 women aged 50-74 years returned their questionnaires: 1480 in the attendee OS group and 4158 in the nonattendee group. Among them, 3537 declared having undergone a recent mammography outside the organized programme (individual, IS group) and 621 declared never having undergone a mammography or having done so more than 2 years ago (NS group). Analyses showed a gradient between the three groups (IS, OS and NS, respectively) in their association with breast cancer screening practices considering three factors: an increasing gradient was observed for renunciation of basic healthcare for financial reasons, a decreasing gradient in the regular visit to a medical gynaecologist and having had a Pap smear in the last 3 years. Three other variables that showed a decreasing gradient are: living with a partner, current use of hormone replacement therapy and having had a check-up in the last 5 years. In conclusion, the main differences between breast cancer screening practices were largely associated with difficulties in healthcare access, considering regular gynaecological visits in particular.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Aged
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / epidemiology
  • Cross-Sectional Studies
  • Female
  • France
  • Health Services Accessibility* / statistics & numerical data
  • Humans
  • Mammography / statistics & numerical data
  • Mass Screening / methods*
  • Middle Aged
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Social Class
  • Surveys and Questionnaires