EVIDENCE BASED PUBLIC HEALTH POLICY AND PRACTICE

Socioeconomic deprivation, travel distance, location of service, and uptake of breast cancer screening in North Derbyshire, UK

Ravi Maheswaran¹, Tim Pearson¹, Hannah Jordan¹, David Black²

¹ Public Health GIS Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
² Chesterfield Primary Care Trust, Chesterfield, UK

Correspondence to:
Correspondence to:
Dr R Maheswaran
Public Health GIS Unit, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; r.maheswaran{at}sheffield.ac.uk

Background and aim: This study examined the association between socioeconomic deprivation, travel distance, urban-rural status, location and type of screening unit, and breast screening uptake. Screening was provided at 13 locations—1 fixed and 12 mobile (3 at non-health locations).

Methods: The study examined data from 1998 to 2001 for 34 868 women aged 50–64 years, calculated road travel distance, used 1991 enumeration district level Townsend socioeconomic deprivation scores, and a ward level urban-rural classification.

Results: Odds of attendance for screening decreased with increasing socioeconomic deprivation, with an adjusted odds ratio of 0.64 (95%CI 0.59 to 0.70) in the most deprived relative to the least deprived category. 87% of women lived within 8 km of their screening location. The odds ratio for a 10 km increase in distance was 0.87 (95%CI 0.79 to 0.95). The odds ratios were 1.18 (95%CI 1.08 to 1.28) for screening at a non-health relative to a health location, 1.00 (95%CI 0.94 to 1.07) for the fixed site relative to the mobile unit and 1.00 (95%CI 0.91 to 1.09) for mainly rural relative to mainly urban areas.

Conclusions: Socioeconomic inequality in breast screening uptake seems to persist in an established service. There was a small decrease with increasing distance, no difference between fixed and mobile units, and no difference between urban and rural areas but uptake seemed to be higher at non-health sites. Further work is needed to identify effective methods of decreasing socioeconomic inequalities in uptake and to confirm if non-health locations are associated with higher screening uptake.

Keywords: breast cancer; screening; socioeconomic deprivation; travel distance

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

In this issue

Carlos Alvarez-Dardet, John R Ashton
J Epidemiol Community Health 2006 60: 185. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Cuthbertson, S. A., Goyder, E. C., Poole, J. (2009). Inequalities in breast cancer stage at diagnosis in the Trent region, and implications for the NHS Breast Screening Programme. J Public Health (Oxf) 31: 398-405 [Abstract] [Full Text]  
• Deutekom, M., van Rijn, A. F., Dekker, E., Blaauwgeers, H., Stronks, K., Fockens, P., Essink-Bot, M.-L. (2009). Uptake of faecal occult blood test colorectal cancer screening by different ethnic groups in the Netherlands. Eur J Public Health 19: 400-402 [Abstract] [Full Text]  
• Moser, K., Patnick, J., Beral, V. (2009). Inequalities in reported use of breast and cervical screening in Great Britain: analysis of cross sectional survey data. BMJ 338: b2025-b2025 [Abstract] [Full Text]  
• Zackrisson, S., Lindstrom, M., Moghaddassi, M., Andersson, I., Janzon, L. (2007). Social predictors of non-attendance in an urban mammographic screening programme: A multilevel analysis. Scand J Public Health 35: 548-554 [Abstract]