The association between cervical cancer screening participation and the deprivation index of the location of the family doctor's office.

Autor: Serman F; Department of General Medicine, School of Medicine, Lille University, Lille, France., Favre J; Department of General Medicine, School of Medicine, Lille University, Lille, France., Deken V; Department of Public Health, University Hospital of Lille, Lille University, Lille, France., Guittet L; Department of Epidemiological Research and Evaluation, University Hospital Caen, Caen, France.; INSERM U1086 « Anticipe », University Hospital Caen, Normandie University, Caen, France.; Department of General Medicine, Medical School, Normandie University, Caen, France., Collins C; Irish College of General Practitioners, Dublin, Ireland., Rochoy M; Department of General Medicine, School of Medicine, Lille University, Lille, France., Messaadi N; Department of General Medicine, School of Medicine, Lille University, Lille, France., Duhamel A; Department of Public Health, University Hospital of Lille, Lille University, Lille, France., Launay L; Department of Epidemiological Research and Evaluation, University Hospital Caen, Caen, France.; INSERM U1086 « Anticipe », University Hospital Caen, Normandie University, Caen, France.; Department of General Medicine, Medical School, Normandie University, Caen, France., Berkhout C; Department of General Medicine, School of Medicine, Lille University, Lille, France., Raginel T; INSERM U1086 « Anticipe », University Hospital Caen, Normandie University, Caen, France.; Department of General Medicine, Medical School, Normandie University, Caen, France.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 May 15; Vol. 15 (5), pp. e0232814. Date of Electronic Publication: 2020 May 15 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0232814
Abstrakt: Background: Cervical cancer screening rates are known to be strongly associated with socioeconomic status. Our objective was to assess whether the rate is also associated with an aggregated deprivation marker, defined by the location of family doctors' offices.
Methods: To access this association, we 1) collected data from the claim database of the French Health Insurance Fund about the registered family doctors and their enlisted female patients eligible for cervical screening; 2) carried out a telephone survey with all registered doctors to establish if they were carrying out Pap-smears in their practices; 3) geotracked all the doctors' offices in the smallest existing blocks of socioeconomic homogenous populations (IRIS census units) that were assigned a census derived marker of deprivation, the European Deprivation Index (EDI), and a binary variable of urbanization; and 4) we used a multivariable linear mixed model with IRIS as a random effect.
Results: Of 348 eligible doctors, 343 responded to the telephone survey (98.6%) and were included in the analysis, encompassing 88,152 female enlisted patients aged 25-65 years old. In the multivariable analysis (adjusted by the gender of the family doctor, the practice of Pap-smears by the doctor and the urbanization of the office location), the EDI of the doctor's office was strongly associated with the cervical cancer screening participation rate of eligible patients (p<0.001).
Conclusion: The EDI linked to the location of the family doctor's office seems to be a robust marker to predict female patients' participation in cervical cancer screening.
Competing Interests: The authors have declared that no competing interests exist
Databáze: MEDLINE
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