The impact of interventions to improve attendance in female cancer screening among lower socioeconomic groups: a review.
OBJECTIVE
To review the scientific evidence on the effectiveness of interventions to promote attendance to breast and cervical cancer screening among lower socioeconomic groups.


METHODS
We performed a computerized literature search looking for relevant papers published between 1997 and 2006. Papers were classified into three groups based on the type of intervention evaluated: (1) implementation of organized population screening programs; (2) different strategies of enhancing attendance within an organized program; (3) local interventions in disadvantaged populations.


RESULTS
The available evidence supports the hypothesis that while organized population screening programs are successful in increasing overall participation rates, they may not per se substantially reduce social inequalities. Some strategies were consistently found to enhance access to screening among lower socioeconomic groups, including cost-reducing interventions (e.g. offering free tests and eliminating geographical barriers), a greater involvement of primary-care physicians and individually tailored pro-active communication that addresses barriers to screening.


CONCLUSIONS
Evidence from studies suggests that the attendance of deprived women to cancer screening can be improved with organized screening programs tailored to their needs. The same may apply to the prevention of adverse outcomes of other health conditions, such as hypertension, hypercholesterolemia, and diabetes.
Spadea
Teresa
T
Regional Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, Italy. teresa.spadea@epi.piemonte.it
Bellini
Silvia
S
Kunst
Anton
A
Stirbu
Irina
I
Costa
Giuseppe
G
D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007558:Italy; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011203:Poverty; D040241:Social Marketing; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*