Inequalities in reported use of breast and cervical screening in Great Britain: analysis of cross sectional survey data

• Published in: BMJ 2009-06, Vol.338 (7709), p.1480-1484
• Main Authors: Moser, Kath, Patnick, Julietta, Beral, Valerie
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Age groups; Aged; Biological and medical sciences; Breast Cancer; Breast Neoplasms - prevention & control; Cancer screening; Cervical cancer; Clinical Diagnostic Tests; Demographics; Early Detection of Cancer; Epidemiologic Methods; Ethnic Studies; Ethnicity; Female; General aspects; General practice; Households; Housing; Humans; Hysterectomy; Mammography; Mammography - statistics & numerical data; Mass Screening - statistics & numerical data; Medical sciences; Medical screening; Middle Aged; P values; Population; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Radiology; Radiology (Diagnostics); Screening; Screening (Epidemiology); Screening (Public Health); Sociodemographics; Socioeconomic Factors; Socioeconomics; Uterine Cervical Neoplasms - prevention & control; Vaginal smears; Vaginal Smears - statistics & numerical data; White people; Women; Womens health
• ISSN: 0959-8138; 0959-8146; 0959-535X; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.b2025

Objective To investigate the relation between women’s reported use of breast and cervical screening and sociodemographic characteristics.Design Cross sectional multipurpose survey.Setting Private households, Great Britain.Population 3185 women aged 40-74 interviewed in the National Statistics Omnibus Survey 2005-7.Main outcome measures Ever had a mammogram, ever had a cervical smear, and, for each, timing of most recent screen.Results 91% (95% confidence interval 90% to 92%) of women aged 40-74 years reported ever having had a cervical smear, and 93% (92% to 94%) of those aged 53-74 years reported ever having had a mammogram; 3% (2% to 4%) of women aged 53-74 years had never had either breast or cervical screening. Women were significantly more likely to have had a mammogram if they lived in households with cars (compared with no car: one car, odds ratio 1.67, 95% confidence interval 1.06 to 2.62; two or more cars, odds ratio 2.65, 1.34 to 5.26), and in owner occupied housing (compared with rented housing: own with mortgage, odds ratio 2.12, 1.12 to 4.00; own outright, odds ratio 2.19, 1.39 to 3.43), but no significant differences by ethnicity, education, occupation, or region were found. For cervical screening, ethnicity was the most important predictor; white British women were significantly more likely to have had a cervical smear than were women of other ethnicity (odds ratio 2.20, 1.41 to 3.42). Uptake of cervical screening was greater among more educated women but was not significantly associated with cars, housing tenure, or region.Conclusions Most (84%) eligible women report having had both breast and cervical screening, but 3% report never having had either. Some inequalities exist in the reported use of screening, which differ by screening type; indicators of wealth were important for breast screening and ethnicity for cervical screening. The routine collection within general practice of additional sociodemographic information would aid monitoring of inequalities in screening coverage and inform policies to correct them.