Abstract
BackgroundPrevious research showed that deprived individuals are less likely to attend breast screening and those providing intense amounts of informal care tend to be more deprived than non-caregivers. The aim of this study was to examine the relationship between informal caregiving and uptake of breast screening and to determine if socio-economic gradients in screening attendance were explained by caregiving responsibilities.MethodsA database of breast screening histories was linked to the Northern Ireland Longitudinal Study, which links information from census, vital events and health registration datasets. The cohort included women aged 47 - 64 at the time of the census eligible for breast screening in a three-year follow-up period. Cohort attributes were recorded at the Census. Multivariate logistic regression was used to examine the relationship between informal caregiving and uptake of screening using STATA version 10.Results37,211 women were invited for breast screening of whom 27,909 (75%) attended; 23.9% of the cohort were caregivers. Caregivers providing <20 hours of care/week were more affluent, while those providing >50 hours/week were more deprived than non-caregivers. Deprived women were significantly less likely to attend breast screening; however, this was not explained by caregiving responsibilities as caregivers were as likely as non-caregivers to attend (Odds Ratio 0.97; 95% confidence intervals 0.88, 1.06).ConclusionsWhile those providing the most significant amounts of care tended to be more deprived, caregiving responsibilities themselves did not explain the known socio-economic gradients in breast screening attendance. More work is required to identify why more deprived women are less likely to attend breast screening.
Highlights
Previous research showed that deprived individuals are less likely to attend breast screening and those providing intense amounts of informal care tend to be more deprived than non-caregivers
Breast cancer survival rates in the United Kingdom (UK) are lower than in other parts of Europe and there is evidence to suggest that this is in part explained by the presentation at diagnosis with more advanced disease among UK patients compared to their European counterparts [2,3]
One of the most efficient ways to increase the rate of early cancer detection is through national screening programmes [4] and early diagnosis through the NHS Breast Cancer Screening Programme is considered to have contributed significantly to the overall reduction in breast cancer mortality in the UK over the past 20 years[5,6]
Summary
Previous research showed that deprived individuals are less likely to attend breast screening and those providing intense amounts of informal care tend to be more deprived than non-caregivers. A number of studies have shown that the uptake of breast screening is associated with a variety of socio-economic factors [9,10]; for example, in a recent study, Moser et al showed for 3,185 respondents to the National Statistics Omnibus Survey, that car ownership and housing tenure were significant predictors of attendance for mammography [11]. It not clear why more deprived individuals are less likely to attend breast screening. Previous work has shown that those providing more intense amounts of informal care (often defined as 50 + hours/week) tend to be more deprived than noncaregivers, and of caregivers providing fewer hours of care [12,13]
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