Likelihood Of Having Breast And Cervical Screening Associated To Wealth And Ethnicity

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Main Category: Women's Health / Gynecology
Also Included In: Breast Cancer;  Cancer / Oncology
Article Date: 17 Jun 2009 - 5:00 PDT

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A research published today on bmj.com reports that Caucasian British women are more likely to have had a mammogram. And there is more probability that women owning cars or homes have had a mammogram.

The authors are Kath Moser and team at the University of Oxford. They draw attention to the need for more information on patient´s ethnicity, as well as some indicators of their socioeconomic status. Data should be collected consistently in general practice in order to document inequalities in health screening.

Women in England aged from fifty to seventy are invited by the NHS Cancer Screening Programmes for breast screening every three years. And, women aged from twenty five to sixty four are encouraged to submit to cervical screening every three to five years.

The authors commissioned ONS to ask women aged between forty and seventy four in the National Statistics Omnibus Survey: "Have you ever had a mammogram (x-ray of your breasts)?" and "Have you ever had a cervical screening (the smear test or Pap test)?" and if so, the date of the last time they were screened. Between 2005 and 2007, more than 3,000 women were interviewed.

An encouraging fact is that the findings report that 84 percent of the eligible women have had both breast and cervical screening. Only 3 percent of women have never had either. Results also show that there is a higher probability for women living in households with cars and owning their home (and not renting) to have had a mammogram.

A key factor in determining if women attend cervical screening is ethnicity. White British women are far more likely to have had a cervical screening than women from other ethnic backgrounds. Cervical screening attendance was also higher among more educated women. However, it was not linked to wealth (car or home ownership) or the region of the country where women lived.

In conclusion, the authors remark that this study is important for the reason that "it provides new evidence on inequalities in screening showing that they are characterized by indicators of household wealth in the case of breast screening and ethnicity in the case of cervical screening. It therefore also demonstrates the need for patient ethnicity and some indicator of socio-economic position to be routinely collected in general practice. This would facilitate the routine monitoring of coverage of screening among different ethnic and socioeconomic groups and could be used to inform policies to reduce inequalities in coverage."

Professor Julietta Patnick, Director, NHS Cancer Screening Programmes, explained:

"This is the first time we've asked women directly to tell us about their experiences of breast and cervical screening. The findings have been very interesting with women saying they were more likely to have had a mammogram if they owned their own homes and had a car, no matter what their background or where they came from. This differed from cervical screening where ethnicity and education levels were found to have a direct link with the likelihood of being screened".

"The challenge for the screening programmes is to make sure our services reach all parts of the population so we can reduce health inequalities. On the one hand we need to look at where mammography is available to make it easy for women to get to their appointments without having to travel too far; while with cervical screening, we need to ensure we're providing information in an accessible way so all women can make informed decisions about whether or not to take up their invitation."

"Inequalities in reported use of breast and cervical screening in Great Britain: analysis of cross sectional survey data"
Kath Moser, senior researcher, Julietta Patnick, visiting professor, director, Valerie Beral, director
BMJ 2009; 338:b2025
doi:10.1136/bmj.b2025
bmj.com

Written by Stephanie Brunner (B.A.)
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