To what extent is women's economic situation associated with cancer screening uptake when nationwide screening exists? A study of breast and cervical cancer screening in France in 2010.
OBJECTIVE
In France, larger social inequalities are reported for cervical cancer screening, based on individual practice, than for breast cancer screening for which organized screening exists. Our aim was to investigate the association between women's economic situation and breast and cervical cancer screening.


METHODS
We used data from a large French national health survey conducted in 2010. The economic situation was assessed using the number of adverse economic conditions respondents were facing, based on three variables (low income, lacking food, and perceived financial difficulties). Logistic regressions were adjusted for socioeconomic and sociodemographic characteristics, healthcare use and insurance, and health behaviors.


RESULTS
Mammography was less frequent among women experiencing two or more adverse economic conditions, whereas Pap smear was less frequent among women experiencing at least one adverse economic condition. For both screenings, higher rates were observed among women who lived in the Paris region. Sociodemographic indicators and health behaviors were associated with Pap smear, whereas healthcare use and insurance characteristics were associated with mammography.


CONCLUSIONS
The women's economic situation is an important determinant of breast and cervical cancer screening in France in 2010. Alleviating economic barriers to female cancers screening should be a priority in future programs implementation.
INSERM, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, 75013, Paris, France, gwenn.menvielle@inserm.fr.
Gwenn
G
Menvielle
Jean-Baptiste
JB
Richard
Virginie
V
Ringa
Rosemary
R
Dray-Spira
François
F
Beck
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000191:economics*; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000191:economics*; D005260:Female; D005602:France; D006297:Health Services Accessibility / Q000191:economics*; D006801:Humans; D016015:Logistic Models; D008327:Mammography / Q000191:economics; D008403:Mass Screening / Q000191:economics / Q000379:methods / Q000458:organization & administration; D008875:Middle Aged; D009313:National Health Programs; D065006:Papanicolaou Test / Q000191:economics; D010342:Patient Acceptance of Health Care; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000191:economics*