Mélanie Araujo1, Jeanna-Eve Franck2, Emmanuelle Cadot3, Arnaud Gautier4, Pierre Chauvin5, Laurent Rigal6, Virginie Ringa7, Gwenn Menvielle8. 1. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France. Electronic address: melanie.araujo78@gmail.com. 2. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France. Electronic address: jeanna-eve.franck@inserm.fr. 3. IRD, UMR 5569, HydroSciences, F-34394 Montpellier, France. Electronic address: emmanuelle.cadot@ird.fr. 4. Santé Publique France, French national public health agency, F-94415 Saint-Maurice, France. Electronic address: GAUTIER@santepubliquefrance.fr. 5. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France. Electronic address: pierre.chauvin@inserm.fr. 6. INSERM, Epidemiology and Population Health Research Centre (CESP), U1018, Gender, Sexuality and Health Team, F-94276 Le Kremlin-Bicêtre, France; Univ Paris-Sud, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; INED, F-75012 Paris, France. Electronic address: laurent.rigal@inserm.fr. 7. INSERM, Epidemiology and Population Health Research Centre (CESP), U1018, Gender, Sexuality and Health Team, F-94276 Le Kremlin-Bicêtre, France; Univ Paris-Sud, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France; INED, F-75012 Paris, France. Electronic address: virginie.ringa@inserm.fr. 8. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France. Electronic address: gwenn.menvielle@inserm.fr.
Abstract
BACKGROUND: Some contextual factors associated with participation in cervical cancer screening are reported in the literature, but few studies have examined their combined effect. Our objective was to assess the role of contextual characteristics, separately and in combination, in participation in cervical cancer screening in France. METHODS: Marginal Poisson regression models - taking into account the correlation between women in a given commune - were conducted using data from the Baromètre Santé 2010 survey. The characteristics of the commune of residence of the women studied were the potential spatial accessibility to general practitioners (GP) and gynecologists, the agglomeration category, and the socioeconomic level. RESULTS: The analyses were performed in 3380 women, 88.2% of whom were up to date with their cervical cancer screening. Once the individual characteristics were taken into account, the screening participation rate was similar in all the communes, with the exception of those with poor access to a gynecologist and good access to a GP, where the rate was 6% lower (95%CI: 0.5-11%) than in the communes with good access to both GP and gynecologist. The same association with accessibility was observed in small agglomerations. Compared to women living in the more advantaged communes, the screening participation rate was 8% (2-12%) lower in those living in the more disadvantaged ones, except when accessibility to both types of physician was high. DISCUSSION: We observed an association between potential spatial accessibility to care in women's residential communities and their cervical cancer screening practices, in particular in small agglomerations, rural communes, and more disadvantaged communes.
BACKGROUND: Some contextual factors associated with participation in cervical cancer screening are reported in the literature, but few studies have examined their combined effect. Our objective was to assess the role of contextual characteristics, separately and in combination, in participation in cervical cancer screening in France. METHODS: Marginal Poisson regression models - taking into account the correlation between women in a given commune - were conducted using data from the Baromètre Santé 2010 survey. The characteristics of the commune of residence of the women studied were the potential spatial accessibility to general practitioners (GP) and gynecologists, the agglomeration category, and the socioeconomic level. RESULTS: The analyses were performed in 3380 women, 88.2% of whom were up to date with their cervical cancer screening. Once the individual characteristics were taken into account, the screening participation rate was similar in all the communes, with the exception of those with poor access to a gynecologist and good access to a GP, where the rate was 6% lower (95%CI: 0.5-11%) than in the communes with good access to both GP and gynecologist. The same association with accessibility was observed in small agglomerations. Compared to women living in the more advantaged communes, the screening participation rate was 8% (2-12%) lower in those living in the more disadvantaged ones, except when accessibility to both types of physician was high. DISCUSSION: We observed an association between potential spatial accessibility to care in women's residential communities and their cervical cancer screening practices, in particular in small agglomerations, rural communes, and more disadvantaged communes.
Authors: Alejandra González; Ricardo Sánchez; Milena Camargo; Sara Cecilia Soto-De León; Luisa Del Río-Ospina; Luis Hernando Mora; Edwin Ramírez; Anny Alejandra Rodríguez; Paula Hurtado; Manuel Elkin Patarroyo; Manuel Alfonso Patarroyo Journal: PLoS One Date: 2022-01-25 Impact factor: 3.240