Low-income women participate less in cancer screening

A study conducted by the University of Coimbra.

A study by the University of Coimbra (UC) revealed that low-income European women continue to participate less in screening for breast and cervical cancer.

The study analyzed the participation of women from 30 European countries in oncology screening for breast cancer (with mammography) and cervical cancer (through cytology), and researchers Carlotta Quintal and Michaela Antunes concluded that there is still “a significant disparity in the conduct of these examinations among women with high and low income.

The study’s conclusions were presented in a scientific article published in the Journal of Social Science & Medicine, which also highlights “cases of overuse (excessive testing) and overuse (no testing) in women who are part of the target groups that should be subject to for regular examination.

According to Carlota Quintal, “There is evidence that breast and cervical cancer screenings are closely associated with lower rates of cancer-related morbidity and mortality, and it is important to monitor participation rates among target groups, as well as inequality.”

“Worldwide, breast cancer is the fourth most common type of cancer among women, while cervical cancer is the fourth most common cancer among women,” he said.

Researchers at the Center for Research in Economics and Management and professors in the University of California School of Economics analyzed screening in 30 countries using data provided by the European Health Interview Survey on breast and cervical cancer screenings conducted between 2013 and 2015.

Among these countries, Bulgaria and Romania stand out with low levels of participation and high inequality of access between high- and low-income women. Regarding the highest rates of participation, on mammography, Sweden, France and Finland stand out, and in cytology, the Czech Republic, Austria and Luxembourg stand out.

Michaela Antunes said that Portugal “has one of the highest rates of participation in the case of mammography in the target group (between 50 and 69 years old), immediately after Finland, with no signs of inequality, both in the case of screening within the recommended period ( two years) or severe underuse.”

Michaela Antunes explained that the results on cytology performance are less favorable, adding that Portugal “is seen in the group of countries where overuse (the percentage of women screened in the past 12 months is higher than the expected value) is likely to be a phenomenon concentrated on women with high income.

Referring to the frequency of these screening tests, Carlotta Quintal stressed that “the results are very clear with regard to underutilization (women in the target group who have never taken the test), with these cases being concentrated in the poorest women.”

On the other hand, “the analysis is also clear regarding the overuse (associated with the excessive frequency of medical examinations) in both examinations, being a widespread phenomenon in Europe,” and in some countries, “it appears to be cross-sectional to all” tests. income groups,” and in other cases, “it is a phenomenon associated with women with higher incomes.”

In this context, Michaela Antunes advocated the importance of “paying more attention to the different situations identified in this framework of analysis, i.e. under-utilization in age groups close to the minimum age specified for screening”, because these women are at risk of conversion. to a situation that is defined as a “missed opportunity”.

The researcher also considered that “overuse, associated either with a frequency of examination higher than the recommended, or with examination before or after the recommended age, should be investigated”, not only because of the waste of resources it represents, but also “by the need to ensure that women They make informed choices,” he stressed.