title: Are breast cancer screening practices associated with sociodemographic status and healthcare access? Analysis of a French cross-sectional study.
abstract: The aim of this study was to analyse the role of women's sociodemographic and healthcare access characteristics according to breast cancer screening practices (organized, individual or no screening). A cross-sectional study was set up in seven French districts using a self-administered postal questionnaire. Randomization was stratified proportionally on age and urban/rural status in each district separately among attendees and nonattendees to the organized breast cancer screening programme (OS). A total of 5638 women aged 50-74 years returned their questionnaires: 1480 in the attendee OS group and 4158 in the nonattendee group. Among them, 3537 declared having undergone a recent mammography outside the organized programme (individual, IS group) and 621 declared never having undergone a mammography or having done so more than 2 years ago (NS group). Analyses showed a gradient between the three groups (IS, OS and NS, respectively) in their association with breast cancer screening practices considering three factors: an increasing gradient was observed for renunciation of basic healthcare for financial reasons, a decreasing gradient in the regular visit to a medical gynaecologist and having had a Pap smear in the last 3 years. Three other variables that showed a decreasing gradient are: living with a partner, current use of hormone replacement therapy and having had a check-up in the last 5 years. In conclusion, the main differences between breast cancer screening practices were largely associated with difficulties in healthcare access, considering regular gynaecological visits in particular.
authors.affiliation: French National Institute for Public Health Surveillance, Department of Chronic Diseases and Trauma, Saint-Maurice, France. n.duport@invs.sante.fr
authors.forename: Nicolas
authors.initials: N
authors.lastname: Duport
authors.forename: Rosemary
authors.initials: R
authors.lastname: Ancelle-Park
authors.forename: Marjorie
authors.initials: M
authors.lastname: Boussac-Zarebska
authors.forename: Zoé
authors.initials: Z
authors.lastname: Uhry
authors.forename: Juliette
authors.initials: J
authors.lastname: Bloch
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012923:Social Class; D011795:Surveys and Questionnaires