Sébastien Dawidowicz1,2, Julien Le Breton1,3, Laura Moscova1, Vincent Renard1,3, Sandrine Bercier1,4, Zahida Brixi4, Etienne Audureau3,5, Pascal Clerc3,6, Sylvie Bastuji-Garin3,5, Emilie Ferrat1,3. 1. Primary Care Department, School of Medicine, Université Paris-Est Créteil (UPEC), Créteil, France. 2. Maison de Santé Pluri-professionnelle de Sucy-en-Brie, Sucy-en-Brie, France. 3. DHU A-TVB, IMRB, EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Université Paris-Est Créteil (UPEC), Créteil, France. 4. Association de Dépistage Organisé des Cancers dans le Val-de-Marne, ADOC, Joinville-le-Pont, France. 5. Department of Public Health, Assistance Publique Hôpitaux de Paris (APHP), Henri Mondor Hospital, Créteil, France. 6. Primary Care Department, School of Medicine, Université de Versailles, Versailles, France.
Abstract
BACKGROUND: No study has investigated factors associated with non-participation or partial participation in the different combination patterns of screening programmes for all three cancers, that is, breast, colorectal and cervical cancer. METHODS: In a retrospective cohort study, we sought to describe combinations of cancer screening participation rates among women in the Val-de-Marne area of France and to identify individual and contextual factors associated with non-participation or partial participation. RESULTS: Women aged between 50 and 65 and who were eligible for all three screening programmes (n = 102 219) were analysed in multilevel logistic models, with the individual as the Level 1 variable and the place of residence as the Level 2 variable. The women who did not participate in any of the screening programmes were 34.4%, whereas 30.1%, 24% and 11.5% participated in one, two or all three screening programmes, respectively. Age below 55, a previous false-positive mammography, prior opportunistic mammography only, no previous mammography, membership of certain health insurance schemes (all P < 0.05) and residence in a deprived area (P < 0.001) were independently associated with non-participation or partial participation. We observed a stronger effect of deprivation on non-participation in all three cancers than in combinations of screening programmes. CONCLUSION: Our findings suggest that the health authorities should focus on improving cancer screenings in general rather than screenings for specific types of cancer, especially among younger women and those living in the most socially deprived areas.
BACKGROUND: No study has investigated factors associated with non-participation or partial participation in the different combination patterns of screening programmes for all three cancers, that is, breast, colorectal and cervical cancer. METHODS: In a retrospective cohort study, we sought to describe combinations of cancer screening participation rates among women in the Val-de-Marne area of France and to identify individual and contextual factors associated with non-participation or partial participation. RESULTS:Women aged between 50 and 65 and who were eligible for all three screening programmes (n = 102 219) were analysed in multilevel logistic models, with the individual as the Level 1 variable and the place of residence as the Level 2 variable. The women who did not participate in any of the screening programmes were 34.4%, whereas 30.1%, 24% and 11.5% participated in one, two or all three screening programmes, respectively. Age below 55, a previous false-positive mammography, prior opportunistic mammography only, no previous mammography, membership of certain health insurance schemes (all P < 0.05) and residence in a deprived area (P < 0.001) were independently associated with non-participation or partial participation. We observed a stronger effect of deprivation on non-participation in all three cancers than in combinations of screening programmes. CONCLUSION: Our findings suggest that the health authorities should focus on improving cancer screenings in general rather than screenings for specific types of cancer, especially among younger women and those living in the most socially deprived areas.
Authors: M Solís-Ibinagagoitia; S Unanue-Arza; M Díaz-Seoane; L Martínez-Indart; A Lebeña-Maluf; I Idigoras; I Bilbao; I Portillo Journal: Front Public Health Date: 2020-12-11