[Equity regarding early breast cancer screening according to health insurance status in Colombia].
OBJECTIVE
Evaluating equity regarding early breast cancer detection by comparing real access to and opportunity for mammography screening according to women's social health insurance status.


METHODS
A retrospective follow-up study was conducted on women receiving breast cancer treatment in Bogotá, Cali, Medellin, Bucaramanga and Barranquilla between January 2005 and June 2006. A survey was carried out for collecting data about real access to and the opportunity of having mammography screening. OR and 95% confidence intervals were calculated (adjusted by multivariate logistical regression models) for establishing differences according to health insurance status. Possible interactions were investigated through verisimilarity log-like test.


RESULTS
Women belonging to the contributory regime had a lower probability of real access to mammography screening for early detection of breast cancer than those affiliated to the subsidised regimen (OR=0,46; 0,26-0,72 95 %CI) and poor uninsured women (OR=0,36; 0,13-0,65 95 %CI). Educational level was also associated with real access to mammography, illiterate women having a lower probability of receiving mammography screening than literate women (OR=0,13; 0,02-0,30 95 %CI). Women having government-subsidised health insurance had a lower probability of accessing timely mammography screening (OR=0,10; 0,04-0,41 95 %CI).


CONCLUSIONS
Mammography screening for the early detection of breast cancer is not equitable and such inequality particularly affects the most vulnerable women.
Charry
Ligia Constanza de
LC
Centro de Estudios e Investigación en Salud, Bogotá, Colombia. lcharry@fsfb.org
Carrasquilla
Gabriel
G
Roca
Sandra
S
D001943:Breast Neoplasms / Q000175:diagnosis*; D003105:Colombia; D016001:Confidence Intervals; D004493:Education; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening; D017057:Medically Uninsured; D008875:Middle Aged; D015999:Multivariate Analysis; D011203:Poverty; D012189:Retrospective Studies; D012424:Rural Population; D012943:Social Security; D012959:Socioeconomic Factors; D014505:Urban Population