Abstract
The burden of breast and cervical cancer is changing over time in developing countries. Regular screening is very important for early detection and treatment. In this study, we assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan. A nationwide population- based cross-sectional survey collected information on different variables at the national level. All ever-married women (the phrase is used throughout the text to refer to women who had ever married) aged 15-49 years were included in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at least once in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried out in 8,333 women, aged 20-49 years. Over 39% and 19% of ever-married Jordanian women reported having undergone a breast examination during the previous year and Pap smear examination at least once in their lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous year was 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher for performing BSE (aOR 1.22, 95% CI 1.04-1.43), undergoing CBE (aOR 1.31, 95% CI 1.08-1.60) and undergoing Pap smear examination (aOR 2.38, 95% CI 1.92-2.93) among women in the highest wealth-index quintile as compared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27 for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with an elementary school education or less, who listened to the radio or read the newspaper not more than a few times a year, and nulliparous women were less likely to undergo breast and cervical cancer screening. The rates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economic inequalities in breast and cervical cancer screenings requires concerted outreach activities for women living under socially deprived conditions.
Highlights
Worldwide, cancers are among the leading causes of morbidity and mortality
We assessed inequalities in breast and cervical cancer screening rates in women according to household wealth status, and analyzed the potential predictors associated with a low cancer screening rate in Jordan
To contribute to the literature on the inequalities in breast and cervical cancer screenings depending on the household socioeconomic status (SES), this study sought to assess the inequalities in breast and cervical cancers screening rates among ever-married women aged 20-49 years according to the household wealth status in Jordan and to analyze the possible social predictors contribute substantially to a low cancer screening rate
Summary
Cancers are among the leading causes of morbidity and mortality. An estimated 14 million new cases were diagnosed and 8.2 million cancer-related deaths were recorded in 2012, with an expected rise in the annual cancer cases to 22 million within the 20 years (World Cancer Report, 2014). Breast and cervical cancer are among the most common of all cancers in developing countries (Parkin et al, 2008; Sankaranarayanan and Boffetta, 2010; Jemal et al, 2011). Both breast and cervical cancers have high cure rates when detected and treated early (World Cancer Report, 2014). To contribute to the literature on the inequalities in breast and cervical cancer screenings depending on the household socioeconomic status (SES), this study sought to assess the inequalities in breast and cervical cancers screening rates among ever-married women aged 20-49 years according to the household wealth status in Jordan and to analyze the possible social predictors contribute substantially to a low cancer screening rate
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