Introduction of an organised programme and social inequalities in mammography screening: A 22-year population-based study in Geneva, Switzerland

TitleIntroduction of an organised programme and social inequalities in mammography screening: A 22-year population-based study in Geneva, Switzerland
Publication TypeJournal Article
Year of Publication2017
AuthorsSandoval, JLuis, Theler, J-M, Cullati, S, Bouchardy, C, Manor, O, Gaspoz, J-M, Guessous, I
JournalPreventive Medicine
Volume103
Pagination49–55
ISSN00917435
KeywordsBreast neoplasms, Female, Mammography, Socioeconomic factors
Abstract

In developed countries, breast cancer mortality has decreased during the last decades due to, at least partially, the advent of mammography screening. Organised programmes aim, among other objectives, to increase participation and decrease social inequalities in screening access. We aimed to characterise the evolution of socioeconomic disparities in mammography screening before and after the implementation of an organised programme in Geneva, Switzerland. We included 5345 women, aged 50-74years, without past history of breast cancer who participated in the cross-sectional Bus Santé study, between 1992 and 2014. Outcome measures were: 1) never had a mammography (1992-2014) and 2) never had a mammography or not screened in the two years before being surveyed (subgroup analysis, 2007-2014). Educational attainment was divided in three groups (primary, secondary and tertiary) and period in two (before/after introduction of a screening programme in 1999). We calculated measures of relative and absolute change, including the relative (RII) and slope (SII) indices of social inequality adjusted for age and nationality. We compared the prevalence of screening before and after screening programme implementation using Poisson models. The proportion of unscreened women decreased during the study period from 30.5% to 3.6%. Lower educated women were more frequently unscreened (RII=2.39, p

URLhttp://linkinghub.elsevier.com/retrieve/pii/S0091743517302736
DOI10.1016/j.ypmed.2017.07.025