Are immigrants and nationals born to immigrants at higher risk for delayed or no lifetime breast and cervical cancer screening? The results from a population-based survey in Paris metropolitan area in 2010.
OBJECTIVE
This study aims to compare breast cancer screening (BCS) and cervical cancer screening (CCS) practices of French women born to French parents with those of immigrants and nationals born to immigrants, taking their socioeconomic status into account.


METHODS
The study is based on data collected in 2010 in the Paris metropolitan area among a representative sample of 3000 French-speaking adults. For women with no history of breast or cervical cancer, multivariate logistic regressions and structural equation models were used to investigate the factors associated with never having undergone BCS or CCS.


RESULTS
We confirmed the existence of a strong gradient, with respect to migration origin, for delaying or never having undergone BCS or CCS. Thus, being a foreign immigrant or being French of immigrant parentage were risk factors for delayed and no lifetime screening. Interestingly, we found that this gradient persisted (at least partially) after adjusting for the women's socioeconomic characteristics. Only the level of income seemed to play a mediating role, but only partially. We observed differences between BCS and CCS which suggest that organized CCS could be effective in reducing socioeconomic and/or ethnic inequities.


CONCLUSIONS
Socioeconomic status partially explained the screening nonparticipation on the part of French women of immigrant origin and foreign immigrants. This was more so the case with CCS than with BCS, which suggests that organized prevention programs might reduce social inequalities.
Perre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, INSERM, Paris, France ; Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, Sorbonne Universités, UPMC Univ Paris 06, Paris, France ; Department of General Practice, School of Medicine, UPMC Univ Paris 06, Paris, France.
Claire
C
Rondet
Perre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, INSERM, Paris, France ; Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
Annabelle
A
Lapostolle
Perre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, INSERM, Paris, France ; Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
Marion
M
Soler
Perre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, INSERM, Paris, France ; Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
Francesca
F
Grillo
Centre Maurice Halbwachs, Research Team on Social Inequalities, CNRS, Paris, France.
Isabelle
I
Parizot
Perre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, INSERM, Paris, France ; Pierre Louis Institute of Epidemiology and Public Health, Department of social epidemiology, Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
Pierre
P
Chauvin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*