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Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil

OBJECTIVE: This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from 2003 to 2015 according to education level. METHOD: This is a cross-sectiona...

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Autores principales: Santos, Edige Felipe de Sousa, Monteiro, Camila Nascimento, Vale, Diama Bhadra, Louvison, Marília, Goldbaum, Moisés, Cesar, Chester Luiz Galvão, Barros, Marilisa Berti de Azevedo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868844/
https://www.ncbi.nlm.nih.gov/pubmed/36681068
http://dx.doi.org/10.1016/j.clinsp.2022.100160
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author Santos, Edige Felipe de Sousa
Monteiro, Camila Nascimento
Vale, Diama Bhadra
Louvison, Marília
Goldbaum, Moisés
Cesar, Chester Luiz Galvão
Barros, Marilisa Berti de Azevedo
author_facet Santos, Edige Felipe de Sousa
Monteiro, Camila Nascimento
Vale, Diama Bhadra
Louvison, Marília
Goldbaum, Moisés
Cesar, Chester Luiz Galvão
Barros, Marilisa Berti de Azevedo
author_sort Santos, Edige Felipe de Sousa
collection PubMed
description OBJECTIVE: This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from 2003 to 2015 according to education level. METHOD: This is a cross-sectional population-based study conducted with data from the 2003, 2008, and 2015 editions of the Health Survey of the City of São Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios. RESULTS: The proportion of Pap smears remained stationary at a high level (>89%) throughout the study period, while access to mammography and PSA tests significantly increased in the 2003‒2015 period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period 2003‒2015. CONCLUSIONS: The inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.
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spelling pubmed-98688442023-01-27 Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil Santos, Edige Felipe de Sousa Monteiro, Camila Nascimento Vale, Diama Bhadra Louvison, Marília Goldbaum, Moisés Cesar, Chester Luiz Galvão Barros, Marilisa Berti de Azevedo Clinics (Sao Paulo) Original Articles OBJECTIVE: This study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from 2003 to 2015 according to education level. METHOD: This is a cross-sectional population-based study conducted with data from the 2003, 2008, and 2015 editions of the Health Survey of the City of São Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios. RESULTS: The proportion of Pap smears remained stationary at a high level (>89%) throughout the study period, while access to mammography and PSA tests significantly increased in the 2003‒2015 period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period 2003‒2015. CONCLUSIONS: The inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group. Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo 2023-01-19 /pmc/articles/PMC9868844/ /pubmed/36681068 http://dx.doi.org/10.1016/j.clinsp.2022.100160 Text en © 2022 HCFMUSP. Published by Elsevier España, S.L.U. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Articles
Santos, Edige Felipe de Sousa
Monteiro, Camila Nascimento
Vale, Diama Bhadra
Louvison, Marília
Goldbaum, Moisés
Cesar, Chester Luiz Galvão
Barros, Marilisa Berti de Azevedo
Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil
title Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil
title_full Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil
title_fullStr Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil
title_full_unstemmed Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil
title_short Social inequalities in access to cancer screening and early detection: A population-based study in the city of São Paulo, Brazil
title_sort social inequalities in access to cancer screening and early detection: a population-based study in the city of são paulo, brazil
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868844/
https://www.ncbi.nlm.nih.gov/pubmed/36681068
http://dx.doi.org/10.1016/j.clinsp.2022.100160
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