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

• Published in: European journal of cancer prevention Vol. 17; no. 3; p. 218
• Main Authors: Duport, Nicolas, Ancelle-Park, Rosemary, Boussac-Zarebska, Marjorie, Uhry, Zoé, Bloch, Juliette
• Format: Journal Article
• Language: English
• Published: England 01.06.2008
• Subjects: 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; France
• ISSN: 1473-5709
• DOI: 10.1097/CEJ.0b013e3282b6fde5

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.