National organization of uterine cervical cancer screening and social inequality in France

Eur J Cancer Prev. 2020 Sep;29(5):458-465. doi: 10.1097/CEJ.0000000000000557.

Abstract

Some of the inequality in uterine cervical cancer (UCC) screening uptake are due to the socioeconomic deprivation of women. A national organized screening programme has proven to be effective in increasing the uptake, but may increase socioeconomic inequality. Therefore, we compared inequality in uptake of UCC screening between two French departments, one of which is experimenting an organized screening programme. We used reimbursement data from the main French health insurance scheme to compare screening rates in the municipalities of the two departments over a three-year period. The experimental department had higher screening rates, but the increase in deprivation in municipalities had a greater effect on the decrease in participation in this department. Moreover, while screening rates were higher in urban areas, the negative effect of deprivation on participation was greater in rural areas. Although these departments were compared at the same time under different conditions, socioeconomic inequality between them may have been greater before the experimentation started. However, screening may have led to an increase in socioeconomic inequality between women screened. Special attention must be paid to changes in socioeconomic and geographic inequality in the uptake of UCC screening when the programme is rolled out nationally.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Early Detection of Cancer / statistics & numerical data*
  • Early Detection of Cancer / trends
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Humans
  • Middle Aged
  • National Health Programs / organization & administration*
  • Prognosis
  • Retrospective Studies
  • Socioeconomic Factors*
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology