Inequalities in breast and cervical cancer screening among urban Mexican women.
OBJECTIVE
To examine the equity of screening for breast and cervical cancer among women aged 50 and over living in Mexico City according to the Andersen behavioural model.


METHODS
Logistic regressions were used to analyze the associations of predisposing factors, enabling resources and health needs with mammography and Pap testing among 1323 women aged 50 and over living in Mexico City. The data were taken from SABE, a survey conducted in Latin American and Caribbean cities in 1999-2000.


RESULTS
Referring to the previous two years, use of mammography was less frequent (14.8%) than Pap testing (53.7%). Higher education and having private health insurance were associated with receiving both procedures. Being married was associated with receipt of Pap testing, while being unmarried was associated with mammography. Younger women were more likely to receive a Pap test. Other cancer prevention behaviours were strong predictors of mammography and Pap test use.


CONCLUSIONS
There are inequities in access to cancer screening services among women aged 50 and over in Mexico. Cancer prevention programs need to implement strategies that guarantee free and accessible services independently of social conditions or type of health insurance. The observed clustering of screening services suggests that packaging screening programs for gynaecological cancer could be used to increase coverage.
Couture
Marie-Claude
MC
Département de médecine sociale et préventive, Faculté de médecine, Université de Montréal, CP 6128, Succursale Centre Ville, Montréal, Québec, Canada H3C3J7. marie-claude.couture.1@umontreal.ca
Nguyen
Cat Tuong
CT
Alvarado
Beatriz Eugenia
BE
Velasquez
Luz Delia
LD
Zunzunegui
Maria-Victoria
MV
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000706:statistics & numerical data*; D008800:Mexico; D008875:Middle Aged; D014505:Urban Population; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*