Does lack of resources impair access to breast and cervical cancer screening in Japan?

• Published in: PloS one Vol. 12; no. 7; p. e0180819
• Main Authors: Sano, Hiroshi, Goto, Rei, Hamashima, Chisato
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.07.2017; Public Library of Science (PLoS)
• Subjects: Access control; Adult; Aged; Breast cancer; Breast Neoplasms - diagnosis; Breasts; Cancer; Cancer screening; Care and treatment; Cervical cancer; Cervix; Colorectal cancer; Early Detection of Cancer; Feasibility studies; Female; Gynecology; Health care; Health education; Health facilities; Human papillomavirus; Humans; Japan; Mammography; Mass Screening - statistics & numerical data; Medical screening; Medicine and Health Sciences; Middle Aged; Municipalities; Nurses; Participation; People and Places; Population; Public health; Regression Analysis; Research and Analysis Methods; Rural areas; Rural Population - statistics & numerical data; Screening; Social Sciences; Urban areas; Urban Population - statistics & numerical data; Uterine Cervical Neoplasms - diagnosis; Women's Health Services; Womens health; Young Adult; Japan; United Kingdom > UK; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0180819

To assess the impact of the quantity of resources for breast and cervical cancer screening on the participation rates in screening in clinical settings in municipalities, as well as to clarify whether lack of resources impairs access to cancer screening in Japan. Of the 1,746 municipalities in 2010, 1,443 (82.6%) and 1,469 (84.1%) were included in the analyses for breast and cervical cancer screening, respectively. In order to estimate the effects of the number of mammography units and of gynecologists on the participation rates in breast and cervical cancer screening in clinical settings, multiple regression analyses were performed using the interaction term for urban municipalities. The average participation rate in screening in clinical settings was 6.01% for breast cancer, and was 8.93% for cervical cancer. The marginal effect of the number of mammography units per 1,000 women was significantly positive in urban municipalities (8.20 percent point). The marginal effect of the number of gynecologists per 1,000 women was significantly positive in all municipalities (2.54 percent point) and rural municipalities (3.68 percent point). Lack of mammography units in urban areas and of gynecologists particularly in rural areas impaired access to breast and cervical cancer screening. Strategies are required that quickly improve access for the residents and increase their participation rates in cancer screening.