A nationally quasi-experimental study to assess the impact of partial organized breast and cervical cancer screening programme on participation and inequalities.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100967800 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2407 (Electronic) Linking ISSN: 14712407 NLM ISO Abbreviation: BMC Cancer Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
    • Abstract:
      Background: Organized breast and cervical cancer screening programme could only provide services at no cost for a fraction of socioeconomic-deprived women in China and other low-resource countries, however, little evidence exists for whether such a programme effectively affect the participation and inequalities at the population level.
      Methods: We used individual-level data from a nationally cross-sectional survey in 2014-2015 for breast and cervical cancer screening participation. Data for intervention and comparison grouping were from 2009 to 2014 national breast and cervical cancer screening programme, and counties covered by the programme were divided into intervention group. We assessed the impact of the intervention on the participation rates and the magnitude of inequalities with two approaches: multivariable multilevel logistic regressions adjusting for individual- and region-level covariates; and a difference analysis combined with propensity score matching that estimated the average intervention effect.
      Results: Of 69,875 included women aged 35-64 years, 21,620 were classified into the intervention group and 43,669 into the comparison group for breast cancer screening; and 31,794 into the intervention group, and 33,682 into the comparison group for cervical cancer screening. Participation rate was higher in intervention group than comparison group for breast cancer screening (25.3, 95% confidential interval [CI], 22.8-27.7%, vs 19.1, 17.4-20.7%), and cervical cancer screening (25.7, 23.8-27.7%, vs 21.5, 19.6-23.5%), respectively. Intervention significantly increased the likelihood of participation for both breast cancer and cervical cancer screening in overall women, rural women and urban women, whereas the effect was significantly higher in rural women than urban women. The average intervention effect on the participation rate was an increase of 7.5% (6.7-8.2%) for breast cancer screening, and 6.8% (6.1-7.5%) for cervical cancer screening, respectively. The inequalities were significantly decreased by 37-41% (P < 0.001) between rural and urban, however, were slightly decreased or even increased in terms of age, education status, and household income.
      Conclusions: Organized breast and cervical cancer screening programme targeting for a fraction of women could increase the participation rates at population level, however, it could not significantly affect socioeconomic-introduced inequalities. Further studies are need to conduct time-series analyses and strengthen the causal correlation.
    • References:
      Cancer Causes Control. 2015 May;26(5):713-9. (PMID: 25754108)
      JAMA Oncol. 2015 Jul;1(4):505-27. (PMID: 26181261)
      Am J Public Health. 2013 Sep;103(9):1545-8. (PMID: 23865665)
      MMWR Morb Mortal Wkly Rep. 2019 Jan 11;68(1):14-19. (PMID: 30629571)
      Lancet. 2008 Sep 13;372(9642):928-39. (PMID: 18790316)
      Cancer. 2014 Aug 15;120 Suppl 16:2540-8. (PMID: 25099896)
      Int J Cancer. 2013 Aug 15;133(4):972-83. (PMID: 23400833)
      Lancet Oncol. 2015 Oct;16(14):1405-38. (PMID: 26522157)
      Cancer. 2014 Aug 15;120 Suppl 16:2566-74. (PMID: 25099899)
      Cancer Causes Control. 2016 Sep;27(9):1081-91. (PMID: 27447961)
      Cancer Causes Control. 2015 May;26(5):653-6. (PMID: 25837262)
      Eur J Cancer. 2009 Oct;45(15):2671-8. (PMID: 19695867)
      Lancet Glob Health. 2019 Jun;7(6):e772-e783. (PMID: 31097279)
      JAMA. 2014 Dec 3;312(21):2279-80. (PMID: 25461998)
      N Engl J Med. 2008 Jun 5;358(23):2468-81. (PMID: 18525043)
      Asian Pac J Cancer Prev. 2015;16(17):7401-7. (PMID: 26625735)
      Cancer. 2014 Aug 15;120 Suppl 16:2575-83. (PMID: 25099900)
      Prev Chronic Dis. 2013 Nov 07;10:E183. (PMID: 24199736)
      Cancer. 2007 Jan 15;109(2 Suppl):348-58. (PMID: 17136766)
      Cancer Causes Control. 2015 May;26(5):767-74. (PMID: 25701247)
      Cancer Causes Control. 2016 Aug;27(8):999-1007. (PMID: 27329211)
      Cancer Causes Control. 2015 May;26(5):805-9. (PMID: 25783456)
      Prev Chronic Dis. 2014 Feb 27;11:E29. (PMID: 24576396)
      Int J Cancer. 2019 Mar 1;144(5):1017-1026. (PMID: 30120770)
      Lancet Oncol. 2014 Jun;15(7):e279-89. (PMID: 24872111)
      Int J Epidemiol. 2010 Jun;39(3):757-65. (PMID: 20176587)
      Lancet. 2012 Jan 7;379(9810):47-54. (PMID: 22169105)
      Multivariate Behav Res. 2011 May;46(3):399-424. (PMID: 21818162)
      Lancet. 2008 Nov 29;372(9653):1865-1867. (PMID: 18930539)
      N Engl J Med. 2015 Jun 11;372(24):2353-8. (PMID: 26039523)
      Cancer Med. 2018 May;7(5):2089-2100. (PMID: 29573569)
      Zhonghua Yu Fang Yi Xue Za Zhi. 2016 Apr;50(4):346-50. (PMID: 27029367)
      Am J Public Health. 2014 Jan;104(1):17-22. (PMID: 24228653)
      CA Cancer J Clin. 2018 Nov;68(6):394-424. (PMID: 30207593)
      Am J Prev Med. 2012 Jul;43(1):97-118. (PMID: 22704754)
      Lancet Public Health. 2019 Sep;4(9):e462-e472. (PMID: 31493843)
      Cancer. 2014 Aug 15;120 Suppl 16:2591-6. (PMID: 25099902)
      BMJ. 2009 Jun 16;338:b2025. (PMID: 19531549)
      J Epidemiol. 2015;25(1):50-6. (PMID: 25311031)
      Cancer. 2012 Oct 15;118(20):5110-6. (PMID: 22707306)
    • Grant Information:
      2016YFC0901300, 2016YFC0901301 National Key R&D Program of China
    • Contributed Indexing:
      Keywords: Breast cancer screening; Cervical cancer screening; Impact; Inequality; Participation; Quasi-experimental study
    • Publication Date:
      Date Created: 20201205 Date Completed: 20210419 Latest Revision: 20231110
    • Publication Date:
      20240104
    • Accession Number:
      PMC7716588
    • Accession Number:
      10.1186/s12885-020-07686-4
    • Accession Number:
      33276761