Abstract
BackgroundThe aim was to analyse participation trajectories in organised breast and cervical cancer screening programmes and the association between socioeconomic variables and participation.MethodsA pooled, cross-sectional, time series analysis was used to evaluate secondary data from 17 European countries in 2004–2014.ResultsThe results show that the mammographic screening trend decreases after an initial increase (coefficient for the linear term = 0.40; p = 0.210; 95% CI = − 0.25, 1.06; coefficient for the quadratic term = − 0.07; p = 0.027; 95% CI = − 0.14, − 0.01), while the cervical screening trend is essentially stable (coefficient for the linear term = 0.39, p = 0.312, 95% CI = − 0.42, 1.20; coefficient for the quadratic term = 0.02, p = 0.689, 95% CI = − 0.07, 0.10). There is a significant difference among the country-specific slopes for breast and cervical cancer screening (SD = 16.7, p < 0.001; SD = 14.4, p < 0.001, respectively). No association is found between participation rate and educational level, income, type of employment, unemployment and preventive expenditure. However, participation in cervical cancer screening is significantly associated with a higher proportion of younger women (≤ 49 years) and a higher Gini index (that is, higher income inequality).ConclusionsIn conclusion three messages: organized cancer screening programmes may reduce the socioeconomic inequalities in younger people’s use of preventive services over time; socioeconomic variables are not related to participation rates; these rates do not reach a level of stability in several countries. Therefore, without effective recruitment strategies and tailored organizations, screening participation may not achieve additional gains.
Highlights
The aim was to analyse participation trajectories in organised breast and cervical cancer screening programmes and the association between socioeconomic variables and participation
* Correspondence: marco.bonaudo@unito.it 1Department of Public Health Sciences and Pediatrics, Università di Torino, Via Santena 5 bis, 10126 Turin, Italy Full list of author information is available at the end of the article healthcare practitioner or of their own choice, are adopted by other countries [4]. An assessment of these screening programmes shows that the coverage of the target population and positive response to screening are higher in population-based programmes than in opportunistic screening [5]
The assessment of these screening programmes shows that organized screening programmes for breast and cervical cancer based on an active recruitment strategy are better than opportunistic screenings as far as increasing participation rates are concerned [6, 7]
Summary
The aim was to analyse participation trajectories in organised breast and cervical cancer screening programmes and the association between socioeconomic variables and participation. The assessment of these screening programmes shows that organized screening programmes for breast and cervical cancer based on an active recruitment strategy are better than opportunistic screenings as far as increasing participation rates are concerned [6, 7] Because of their increased population coverage, follow-up and quality control, population-based programmes effectively reduce mortality and control the Gianino et al BMC Public Health (2018) 18:1236 inappropriate use of screening tests [8,9,10,11], whereas opportunistic screening is strongly criticized for using community resources without any demonstrable effect on cancer rates [12]
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