Desigualdades en la realización de mamografías y citologías cervicales en las mujeres españolas según las encuestas nacionales de salud

Abstract

ObjectiveTo analyse the frequencies of mammographic screening, mammographic follow-up through a population-based screening programme, and cytological screening by autonomous community and social class in Spanish women aged 25 to 69 years. MethodsObservational study. The information source was the National Health Surveys (NHS) for 2003, 2006 and 2011. The study population consisted of women aged 25 to 69 years (N=7,844 for NHS-2003, N=12,845 for NHS-2006 and N=7,695 for NHS-2011). The dependent variables were periodic mammographic screening, periodic mammographic screening through a population-based programme, and periodic cervical screening. The independent variables were age, social class (manual/non-manual), autonomous community, the number of years since the start of the programme, and year of the NHS. Prevalence ratios with their 95% confidence intervals (95% CI) were calculated. ResultsIn 2006, participation in periodic population-based mammographic screening was 49.2% among women from a non-manual social class versus 61.5% among those from a manual social class (prevalence ratios NHS-2006: 0.81; 95% CI 0.75-0.88). In NHS-2011, participation was 53.6% among women from a non-manual social class versus 68.0% among those from a manual social class. For NHS-2003, participation in periodic cytological screening was 90.2% among women from a non-manual social class versus 86.7% among those from a manual social class (prevalence ratios NHS-2003: 1.04; 95% CI 1.01-1.06). ConclusionsNo differences were observed by social class in periodic mammographic screening. Population-based breast cancer screening programmes compensate for differences in social class in mammographic follow-up. Cytological screening was more frequent among women from a non-manual social class.