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.
- breast cancer
- socioeconomic deprivation
- travel distance
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Funding: NHS Trent provided core funding for the Public Health GIS Unit. The views expressed in this publication are those of the authors and not necessarily those of the funding organisation
Competing interests: none.