Socioeconomic deprivation, travel distance, location of service, and uptake of breast cancer screening in North Derbyshire, UK
Socioeconomic deprivation, travel distance, location of service, and uptake of breast cancer screening in North Derbyshire, UK
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DOI：
10.1136/jech.200x.038398
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发表时间：
2006-03-01
影响因子：
6.3
通讯作者：
Black, D
中科院分区：
文献类型：
--
作者：
Maheswaran, R;Pearson, T;Black, D
背景和目标：本研究探讨了社会经济贫困、旅行距离、城乡地位、筛查单位的位置和类型与乳腺筛查摄取之间的关系。在13个地点进行了筛查-1个固定地点和12个移动的地点方法：研究检查了1998年至2001年34868名年龄在50-64岁之间的妇女的数据，计算了道路旅行距离，使用了1991年枚举区水平的汤森社会经济剥夺评分，以及病房水平的城乡分类。参加筛查的几率随着社会经济贫困程度的增加而降低，最贫困者相对于最贫困者的调整后比值比为0.64（95%CI 0.59至0.70）。87%的女性居住在筛查地点8公里范围内。距离增加10 km的比值比为0.87（95% CI 0.79至0.95）。优势比为1.18（95% CI 1.08至1.28）在非健康场所相对于健康场所进行筛查，1.00固定部位相对于移动的装置的95% CI（0.94 - 1.07）和1.00（95%CI 0.91至1.09），主要是农村相对于主要城市areas.Conclusions：乳腺癌筛查摄取的社会经济不平等似乎坚持在一个既定的服务。随着距离的增加略有下降，固定和移动的单位之间没有差异，城市和农村地区之间也没有差异，但非卫生场所的吸收似乎更高。需要进一步开展工作，以确定减少社会经济不平等的有效方法，并确认非卫生场所是否与较高的筛查摄取率相关。
Background and aim: This study examined the association between socioeconomic deprivation, travel distance, urban-rural status, location and type of screening unit, and breast screening uptake. Screening was provided at 13 locations-1 fixed and 12 mobile (3 at non-health locations).Methods: The study examined data from 1998 to 2001 for 34 868 women aged 50-64 years, calculated road travel distance, used 1991 enumeration district level Townsend socioeconomic deprivation scores, and a ward level urban-rural classification.Results: Odds of attendance for screening decreased with increasing socioeconomic deprivation, with an adjusted odds ratio of 0.64 (95% CI 0.59 to 0.70) in the most deprived relative to the least deprived category. 87% of women lived within 8 km of their screening location. The odds ratio for a 10 km increase in distance was 0.87 (95% CI 0.79 to 0.95). The odds ratios were 1.18 (95% CI 1.08 to 1.28) for screening at a non-health relative to a health location, 1.00 (95% CI 0.94 to 1.07) for the fixed site relative to the mobile unit and 1.00 (95% CI 0.91 to 1.09) for mainly rural relative to mainly urban areas.Conclusions: Socioeconomic inequality in breast screening uptake seems to persist in an established service. There was a small decrease with increasing distance, no difference between fixed and mobile units, and no difference between urban and rural areas but uptake seemed to be higher at non-health sites. Further work is needed to identify effective methods of decreasing socioeconomic inequalities in uptake and to confirm if non-health locations are associated with higher screening uptake.