Contextual determinants of participation in cervical cancer screening in France, 2010 |
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| Affiliation: | 1. Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d’Épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75012 Paris, France;2. IRD, UMR 5569, HydroSciences, F-34394 Montpellier, France;3. Santé Publique France, French national public health agency, F-94415 Saint-Maurice, France;4. INSERM, Epidemiology and Population Health Research Centre (CESP), U1018, Gender, Sexuality and Health Team, F-94276 Le Kremlin-Bicêtre, France;5. Univ Paris-Sud, UMRS 1018, F-94276 Le Kremlin-Bicêtre, France;6. INED, F-75012 Paris, France;1. Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, United States;2. University of Illinois at Chicago Cancer Center, Cancer Control and Population Science Research Program, Chicago, United States;3. Institute for Health Research and Policy, Chicago, United States;4. Department of Otolaryngology-Head and Neck Surgery, University of Illinois at Chicago, Chicago, United States;5. School of Public Health, University of Alberta, Edmonton, Alberta, Canada;6. University of Illinois at Chicago, Department of Pediatrics, Chicago, United States;7. Survey Research Laboratory, Public Administration, University of Illinois at Chicago, 412 South Peoria Street, Chicago, 60607, United States;8. University of Illinois at Chicago, Department of Medicine, Chicago, United States;9. Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, United States;1. University College London, UK;2. London School of Hygiene and Tropical Medicine, UK;3. MRC Clinical Trials Unit at UCL, London, UK;1. Registre des cancers du Bas-Rhin, Laboratoire d’Épidémiologie et de Santé Publique, EA3430, FMTS, Université de Strasbourg, 4 rue Kirschleger, 67085 Strasbourg CEDEX, France;2. Service de Santé Publique, Hôpitaux Universitaires de Strasbourg, 1 place de l’hôpital, 67091 Strasbourg CEDEX, France;3. Service d’épidémiologie et de biostatistique, Centre Paul Strauss, 3 rue de la porte de l’hôpital, 67065 Strasbourg CEDEX, France;4. Registre des tumeurs de l''Hérault, Centre de Recherche, 208 rue des Apothicaires, 34298 Montpellier CEDEX 5, France;5. Registre des cancers de la Manche, Centre Hospitalier Public du Cotentin, 46 rue du Val de Saire, 50102 Cherbourg-Octeville, France;6. Registre des cancers du Tarn, 1, rue Lavazière BP 37, 81001 Albi CEDEX, France;7. Institut Claudius Regaud, IUCT-O, LEASP – UMR 1027 Inserm – Université Toulouse III, 1 avenue Irène Joliot-Curie, 31059 Toulouse CEDEX 9, France;8. Registre du cancer de la Somme, Service Épidémiologie, Hygiène et Santé Publique, Centre Hospitalier Universitaire Nord, 1 place Victor Pauchet, 80054 Amiens CEDEX 1, France;9. Registre des hémopathies malignes de Basse-Normandie, Unité Fonctionnelle Hospitalo- Universitaire n°0350, Centre Hospitalier Universitaire Nord, avenue de la Côte de Nacre, 14033 Caen CEDEX, France;10. Registre des cancers de Loire-Atlantique et Vendée, Centre Hospitalier Universitaire de Nantes, 50 route de Saint-Sébastien, 44093 Nantes CEDEX 1, France;11. Registre général des cancers de Lille et de sa région, GCS C2RC, Centre Hospitalier Régional Universitaire de Lille Hôpital Calmette, boulevard du Professeur Jules Leclercq, 59037 Lille CEDEX, France;12. Registre des tumeurs du Doubs et du Territoire de Belfort − EA3181, Centre Hospitalier Régional Universitaire de Besançon Saint-Jacques, 2 place Saint-Jacques, 25030 Besançon CEDEX, France;13. Registre des tumeurs digestives du Calvados, Cancers & Préventions – U 1086 Inserm, Centre François Baclesse, 3 avenue du Général Harris, BP 5026 14076 Caen CEDEX 5, France;14. Registre des cancers de l’Isère, Centre Hospitalier Universitaire de Grenoble Pavillon E, boulevard de la Chantourne BP 217, 38043 Grenoble CEDEX 9, France;15. Registre général des tumeurs du Calvados, Cancers & Préventions – U 1086 Inserm, Centre François Baclesse, 3 avenue du Général Harris, BP 5026 14076 Caen CEDEX 5, France;p. Francim: Réseau français des registres des cancers, 31073 Toulouse, France;1. Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom;2. School of Pharmacy, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom;3. Centre of Excellence for Public Health (NI), Centre for Public Health, Queen’s University Belfast, Belfast, Northern Ireland, United Kingdom;1. Division of Population Science, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, United States;2. Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, United States;3. Division of Nephrology, Department of Medicine, Drexel University College of Medicine, Philadelphia, PA 19129, United States;1. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research Unioninkatu 22, 00130 Helsinki, Finland;2. University of Helsinki, Department of Public Health, PO Box 41 (Mannerheimintie 172), FI-00014 University of Helsinki, Finland;3. Faculty of Social Sciences, University of Tampere, FI-33014 University of Tampere, Finland |
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| Abstract: | BackgroundSome contextual factors associated with participation in cervical cancer screening are reported in the literature, but few studies have examined their combined effect. Our objective was to assess the role of contextual characteristics, separately and in combination, in participation in cervical cancer screening in France.MethodsMarginal Poisson regression models – taking into account the correlation between women in a given commune – were conducted using data from the Baromètre Santé 2010 survey. The characteristics of the commune of residence of the women studied were the potential spatial accessibility to general practitioners (GP) and gynecologists, the agglomeration category, and the socioeconomic level.ResultsThe analyses were performed in 3380 women, 88.2% of whom were up to date with their cervical cancer screening. Once the individual characteristics were taken into account, the screening participation rate was similar in all the communes, with the exception of those with poor access to a gynecologist and good access to a GP, where the rate was 6% lower (95%CI: 0.5–11%) than in the communes with good access to both GP and gynecologist. The same association with accessibility was observed in small agglomerations. Compared to women living in the more advantaged communes, the screening participation rate was 8% (2–12%) lower in those living in the more disadvantaged ones, except when accessibility to both types of physician was high.DiscussionWe observed an association between potential spatial accessibility to care in women’s residential communities and their cervical cancer screening practices, in particular in small agglomerations, rural communes, and more disadvantaged communes. |
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| Keywords: | Cervical cancer screening Contextual factors Marginal Poisson regression model Potential spatial accessibility to care Socioeconomic level |
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