Socioeconomic disparities in the uptake of breast and cervical cancer screening in Italy: a cross sectional study.
BACKGROUND
Breast and cervical cancer screening are widely recognized as effective preventive procedures in reducing cancer mortality. The aim of this study was to evaluate the impact of socioeconomic disparities in the uptake of female screening in Italy, with a specific focus on different types of screening programs.


METHODS
A cross-sectional study was conducted using data from the 2004-2005 national health interview survey. A sample of 15, 486 women aged 50-69 years for mammography and one of 35, 349 women aged 25-64 years for Pap smear were analysed. Logistic regression models were used to estimate the association between socioeconomic factors and female screening utilization.


RESULTS
Education and occupation were positively associated with attendance to both screening. Women with higher levels of education were more likely to have a mammogram than those with a lower level (OR = 1.28; 95% CI = 1.10-1.49). Women of intermediate and high occupational classes were more likely to use breast cancer screening (OR = 1.77; 95% CI = 1.55-2.03, OR = 1.63; 95% CI = 1.40-1.91) compared to unemployed women. Women in the highest occupational class had a higher likelihood of cervical cancer screening compared to those in the lowest class (OR = 1.81; 95% CI =  1.63-2.01). Among women who attended screening, those with lower levels of education and lower occupational classes were more likely than more advantaged women to attend organized screening programs rather than being screened on the basis of their own initiative.


CONCLUSIONS
Inequalities in the uptake of female screening widely exist in Italy. Organized screening programs may have an important role in increasing screening attendance and tackling inequalities.
Department of Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy. gdamiani@rm.unicatt.it.
Gianfranco
G
Damiani
Bruno
B
Federico
Danila
D
Basso
Alessandra
A
Ronconi
Caterina Bianca Neve Aurora
CB
Bianchi
Gian Marco
GM
Anzellotti
Gabriella
G
Nasi
Franco
F
Sassi
Walter
W
Ricciardi
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D012923:Social Class; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*