title: Evolution of inequalities in breast and cervical cancer screening in Barcelona: population surveys 1992, 2001, and 2006.
abstract: OBJECTIVE
  To describe and compare breast and cervical cancer screening among women in Barcelona in 1992, 2001, and 2006 by social class, age, and screening approach.
  
  
  METHODS
  This was a study of trends based on analysis of Barcelona health interview surveys for the years 1992 (n=5,003), 2001 (n=10,030), and 2006 (n=6,050). Dependent variables were having regular mammographies (at least every 2 years) and having regular cytologic testing (at least every 3 years). Independent variables were age, social class, and survey year. A descriptive analysis was carried out. To compare prevalence in terms of social class and the years studied, we calculated prevalence differences (PD) and prevalence ratios (PR) by fitting robust Poisson regression models.
  
  
  RESULTS
  In 1992, women aged 40?49 had more regular mammographies than those aged 50?69, with social class inequalities in both age groups. Having cervical cancer screening was more common than having breast cancer screening, with prevalence varying from 46.4% in the low social classes to 59.2% in the high classes. In 2001, breast cancer screening had risen, particularly in women aged 50?69, a tendency that had stabilized by 2006. Inequalities diminished over the period, more markedly in women aged 50?69; PRs of 1.22 and 1.58, respectively, for high and middle social classes with respect to the lowest class in 1992 fell to PRs of 1.07 and 1.08, respectively, in 2006. In the case of cervical cancer screening, inequalities also diminished but not to the same extent.
  
  
  CONCLUSIONS
  Preventive screening for breast and cervical cancer has increased, and the population screening program for breast cancer among women aged 50?69 years appears to contribute more than opportunistic screening for cervical cancer in reducing social class inequalities.
authors: Agència de Salut Pública de Barcelona, Oficina Tècnica Programa de Detecció Precodel Càncer de Mama, Pça. Lesseps, Barcelona, Spain. rpuigpi@aspb.ca
authors: Rosa
authors: R
authors: Puigpinós-Riera
authors: Gemma
authors: G
authors: Serral
authors: Mariona
authors: M
authors: Pons-Vigués
authors: Laia
authors: L
authors: Palència
authors: Maica
authors: M
authors: Rodríguez-Sanz
authors: Carme
authors: C
authors: Borrell
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D012044:Regression Analysis; D012923:Social Class; D013030:Spain; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data*