Equidad en la Detección del Cáncer de Seno en Colombia

Abstract

Evaluating equity regarding early breast cancer detection by comparing real access to and opportunity for mammography screening according to women's social health insurance status. A retrospective follow-up study was conducted on women receiving breast cancer treatment in Bogotá, Cali, Medellin, Bucaramanga and Barranquilla between January 2005 and June 2006. A survey was carried out for collecting data about real access to and the opportunity of having mammography screening. OR and 95% confidence intervals were calculated (adjusted by multivariate logistical regression models) for establishing differences according to health insurance status. Possible interactions were investigated through verisimilarity log-like test. Women belonging to the contributory regime had a lower probability of real access to mammography screening for early detection of breast cancer than those affiliated to the subsidised regimen (OR=0,46; 0,26-0,72 95 %CI) and poor uninsured women (OR=0,36; 0,13-0,65 95 %CI). Educational level was also associated with real access to mammography, illiterate women having a lower probability of receiving mammography screening than literate women (OR=0,13; 0,02-0,30 95 %CI). Women having government-subsidised health insurance had a lower probability of accessing timely mammography screening (OR=0,10; 0,04-0,41 95 %CI). Mammography screening for the early detection of breast cancer is not equitable and such inequality particularly affects the most vulnerable women.