Health inequalities in breast cancer screening

To establish the significant factors that impact upon the likelihood of women attending breast cancer screening. These factors include ethnicity, ethnicity and socioeconomic status, the season of the appointment and the travelling distance for each woman.

All women screened in the Borough of Oldham in 2006 were investigated (n = 5,490). Ethnicity was attributed by analysing their names. Socioeconomic status was designated through their area's average house price. The distance to the screening van was measured from their postcode.

There was a significant difference between Asian (43.7%) and non-Asian (73.7%) attendance (P < 0.05). The difference remained significant when socioeconomic status was accounted for (P < 0.05). Both Asian and non Asian women showed a reduced uptake in poorer areas. Asian women were less likely than non-Asian women to attend breast screening irrespective of their socioeconomic area. Significantly more women attended during autumn (P < 0.05). The travelling distance to the screening van had no effect upon attendance (P = 0.38).

Since the Forrest Report, improvements in diagnosing and treating breast cancer have advanced while improvements in uptake of screening have not. The present study shows that inequalities still exist within the breast cancer screening system. Increasing levels of immigration is resulting in a more diverse nature of our population, thus these inequalities are set to increase. One fundamental objective is to abolish these inequalities. There must be a substantial increase in the uptake rate in both non-Asian and Asian women in all socioeconomic areas so the benefits of better treatment can be accessed. Well structured and funded qualitative research is required to establish why such high levels of nonattendance exist. With the government lengthening the ages women are eligible for screening to 47 to 73 years old, an extra 200,000 women per year are eligible for screening. Unfortunately as has been shown, eligibility does not correlate with attendance – resulting in increasing administration costs and wastage of valuable resources.

Affiliations

1. The Nightingale Centre & Genesis Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, UK

   • J Tollitt
   • , A Jain
   •  & S Astley

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