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Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis
BACKGROUND: Breast cancer is the most commonly occurring cancer among women in low-resourced countries. Reduction of its impacts is achievable with regular screening and early detection. The main aim of the study was to examine the role of wealth stratified inequality in the utilisation breast cance...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285540/ https://www.ncbi.nlm.nih.gov/pubmed/32528677 http://dx.doi.org/10.1186/s13690-020-00410-5 |
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author | Mahumud, Rashidul Alam Alam, Khorshed Keramat, Syed Afroz Renzaho, Andre M. N. Hossain, Md. Golam Haque, Rezwanul Ormsby, Gail M. Dunn, Jeff Gow, Jeff |
author_facet | Mahumud, Rashidul Alam Alam, Khorshed Keramat, Syed Afroz Renzaho, Andre M. N. Hossain, Md. Golam Haque, Rezwanul Ormsby, Gail M. Dunn, Jeff Gow, Jeff |
author_sort | Mahumud, Rashidul Alam |
collection | PubMed |
description | BACKGROUND: Breast cancer is the most commonly occurring cancer among women in low-resourced countries. Reduction of its impacts is achievable with regular screening and early detection. The main aim of the study was to examine the role of wealth stratified inequality in the utilisation breast cancer screening (BCS) services and identified potential factors contribute to the observed inequalities. METHODS: A population-based cross-sectional multi-country analysis was used to study the utilisation of BCS services. Regression-based decomposition analyses were applied to examine the magnitude of the impact of inequalities on the utilisation of BCS services and to identify potential factors contributing to these outcomes. Observations from 140,974 women aged greater than or equal to 40 years were used in the analysis from 14 low-resource countries from the latest available national-level Demographic and Health Surveys (2008–09 to 2016). RESULTS: The population-weighted mean utilisation of BCS services was low at 15.41% (95% CI: 15.22, 15.60), varying from 80.82% in European countries to 25.26% in South American countries, 16.95% in North American countries, 15.06% in Asia and 13.84% in African countries. Women with higher socioeconomic status (SES) had higher utilisation of BCS services (15%) than those with lower SES (9%). A high degree of inequality in accessing and the use of BCS services existed in all study countries across geographical areas. Older women, access to limited mass media communication, being insured, rurality and low wealth score were found to be significantly associated with lower utilisation of BCS services. Together they explained approximately 60% in the total inequality in utilisation of BCS services. CONCLUSIONS: The level of wealth relates to the inequality in accessing BCS amongst reproductive women in these 14 low-resource countries. The findings may assist policymakers to develop risk-pooling financial mechanisms and design strategies to increase community awareness of BCS services. These strategies may contribute to reducing inequalities associated with achieving higher rates of the utilisation of BCS services. |
format | Online Article Text |
id | pubmed-7285540 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72855402020-06-10 Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis Mahumud, Rashidul Alam Alam, Khorshed Keramat, Syed Afroz Renzaho, Andre M. N. Hossain, Md. Golam Haque, Rezwanul Ormsby, Gail M. Dunn, Jeff Gow, Jeff Arch Public Health Research BACKGROUND: Breast cancer is the most commonly occurring cancer among women in low-resourced countries. Reduction of its impacts is achievable with regular screening and early detection. The main aim of the study was to examine the role of wealth stratified inequality in the utilisation breast cancer screening (BCS) services and identified potential factors contribute to the observed inequalities. METHODS: A population-based cross-sectional multi-country analysis was used to study the utilisation of BCS services. Regression-based decomposition analyses were applied to examine the magnitude of the impact of inequalities on the utilisation of BCS services and to identify potential factors contributing to these outcomes. Observations from 140,974 women aged greater than or equal to 40 years were used in the analysis from 14 low-resource countries from the latest available national-level Demographic and Health Surveys (2008–09 to 2016). RESULTS: The population-weighted mean utilisation of BCS services was low at 15.41% (95% CI: 15.22, 15.60), varying from 80.82% in European countries to 25.26% in South American countries, 16.95% in North American countries, 15.06% in Asia and 13.84% in African countries. Women with higher socioeconomic status (SES) had higher utilisation of BCS services (15%) than those with lower SES (9%). A high degree of inequality in accessing and the use of BCS services existed in all study countries across geographical areas. Older women, access to limited mass media communication, being insured, rurality and low wealth score were found to be significantly associated with lower utilisation of BCS services. Together they explained approximately 60% in the total inequality in utilisation of BCS services. CONCLUSIONS: The level of wealth relates to the inequality in accessing BCS amongst reproductive women in these 14 low-resource countries. The findings may assist policymakers to develop risk-pooling financial mechanisms and design strategies to increase community awareness of BCS services. These strategies may contribute to reducing inequalities associated with achieving higher rates of the utilisation of BCS services. BioMed Central 2020-06-10 /pmc/articles/PMC7285540/ /pubmed/32528677 http://dx.doi.org/10.1186/s13690-020-00410-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Mahumud, Rashidul Alam Alam, Khorshed Keramat, Syed Afroz Renzaho, Andre M. N. Hossain, Md. Golam Haque, Rezwanul Ormsby, Gail M. Dunn, Jeff Gow, Jeff Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis |
title | Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis |
title_full | Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis |
title_fullStr | Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis |
title_full_unstemmed | Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis |
title_short | Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis |
title_sort | wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: a pooled decomposition analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285540/ https://www.ncbi.nlm.nih.gov/pubmed/32528677 http://dx.doi.org/10.1186/s13690-020-00410-5 |
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