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Open AccessArticle

Mapping Variation in Breast Cancer Screening: Where to Intervene?

1
Université Rennes, EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins)—EA 7449 Rennes, France
2
Centre régional de coordination des dépistages des cancers Auvergne Rhône Alpes, 5 bis, rue Cléberg, 69322 Lyon CEDEX 05, France
3
Program in Public Health, University of California, Irvine, CA 92697, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(13), 2274; https://doi.org/10.3390/ijerph16132274
Received: 13 May 2019 / Revised: 7 June 2019 / Accepted: 22 June 2019 / Published: 27 June 2019
Small geographic areas with lower mammography screening participation rates may reflect gaps in screening efforts. Our objective was to use spatial analyses to understand disparities in mammography screening use and to identify factors to increase its uptake in areas that need it in Lyon metropolitan area, France. Data for screened women between the ages of 50 and 74 were analyzed. Census blocks of screened and non screened women were extracted from the mammography screening programme 2015–2016 dataset. We used spatial regression models, within a generalized additive framework to determine clusters of census blocks with significantly higher prevalence of non-participation of mammography screening. Smoothed risk maps were crude and adjusted on the following covariates: deprivation index and opportunistic screening. Among 178,002 women aged 50 to 74, 49.9% received mammography screening. As hypothesized, women living in highly deprived census blocks had lower participation rates compared to less deprived blocks, 45.2% vs. 51.4% p < 0.001. Spatial analyses identified four clusters, one located in an urban area and three in suburban areas. Moreover, depending on the location of the cluster, the influence came from different variables. Knowing the impact of site-specific risk factors seems to be important for implementing an appropriate prevention intervention. View Full-Text
Keywords: mammography screening; opportunistic screening; breast cancer; spatial variation; mapping; socioeconomic inequalities mammography screening; opportunistic screening; breast cancer; spatial variation; mapping; socioeconomic inequalities
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Padilla, C.M.; Painblanc, F.; Soler-Michel, P.; Vieira, V.M. Mapping Variation in Breast Cancer Screening: Where to Intervene? Int. J. Environ. Res. Public Health 2019, 16, 2274.

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