Factors influencing the uptake of screening services for breast and cervical cancer in Taiwan.
OBJECTIVE
Cervical cancer and breast cancer have had the first and second highest occurrence rates among women in Taiwan since 1981 and have also been two of the leading causes of cancer death. In order to more effectively promote preventive medical care programs, it is important to identify the key determinants of women's behavior regarding their decisions to engage in screenings. This study aims to identify the major factors that affect the utilization of breast and cervical cancer screening among women in Taiwan, who are covered by universal National Health Insurance.


METHODS
Data were obtained from the 2001 National Health Interview Survey for the Taiwan area and targeted women between 30 and 75 years old. The sample size consisted of 5,611 individuals for Papanicolaou (Pap) tests and breast examinations by a doctor. For breast ultrasounds and mammograms, 3,875 individuals were included. The propensity among women in Taiwan to use the two types of screening services, i.e., Pap test and breast examinations, were estimated by maximum likelihood probit regressions.


RESULTS
The findings in this study show that the likelihood of a woman receiving a Pap test or a clinical breast examination depends on a variety of factors such as age, marital status, income level, education, and health status. Women with lower socioeconomic status were found to be much less likely to undergo the freely available cancer screening services. In addition, healthy behavior, such as not smoking and engaging in exercise, had a positive effect on the uptake of screening.


CONCLUSIONS
The results of this study enable us to understand more thoroughly the characteristics of women who undergo a Pap test and breast examination, as well as the factors that influence them in Taiwan. The findings can help formulate related policies that are directed at removing the barriers to accessing medical care and targeting those at-risk groups. This analysis provides new evidence of the factors affecting the utilization of preventive care among women in a developing country, which are comparable to those of other countries, and may shed further light on the issue of promoting cancer screening and women's health.
Lin
Shin-Jong
SJ
Department of Economics, Ming Chuan University, Taoyuan, Taiwan. joysjlin@ms41.hinet.net
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D065006:Papanicolaou Test; D012044:Regression Analysis; D012307:Risk Factors; D013624:Taiwan; D014463:Ultrasonography; D019472:Universal Health Insurance; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data*