Socioeconomic disparities in Papanicolaou test utilization in Western Iran

Abstract Background Cervical cancer remains the fourth most frequently diagnosed cancer among women, and its impact is particularly significant in women residing in less developed countries. This study aims to assess socioeconomic inequality in using Papanicolaou tests, commonly known as Pap tests,...

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Main Authors: Bahare Safari-Faramani, Roya Safari-Faramani, Farid Najafi, Davoud Khorasani Zavareh, Ali Kazemi Karyani, Mitra Darbandi
Format: Article
Language:English
Published: BMC 2024-02-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-024-17927-x
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author Bahare Safari-Faramani
Roya Safari-Faramani
Farid Najafi
Davoud Khorasani Zavareh
Ali Kazemi Karyani
Mitra Darbandi
author_facet Bahare Safari-Faramani
Roya Safari-Faramani
Farid Najafi
Davoud Khorasani Zavareh
Ali Kazemi Karyani
Mitra Darbandi
author_sort Bahare Safari-Faramani
collection DOAJ
description Abstract Background Cervical cancer remains the fourth most frequently diagnosed cancer among women, and its impact is particularly significant in women residing in less developed countries. This study aims to assess socioeconomic inequality in using Papanicolaou tests, commonly known as Pap tests, which are crucial for detecting cervical cancer. The research also seeks to decompose this inequality, identifying its contributing factors. This investigation is conducted within a sizable population-based study focused on the Kurdish population, with an additional examination of potential variations between urban and rural areas. Method The study utilized baseline data from the Ravansar Non-Communicable Disease Cohort Study (RaNCD), involving 3,074 ever-married women aged 35–65. Asset data was employed to determine socioeconomic status (SES), and Principal Component Analysis was applied. The uptake of Papanicolaou tests was assessed for inequality using the Concentration Index (Cn). Additionally, decomposition analysis was conducted to identify and understand the factors contributing to socioeconomic inequality. Results The study found that overall, 86% of women reported having undergone cervical cancer screening at least once in their lifetime. The Concentration Index (Cn) for the total population was 0.21 (p < 0.0001), indicating a higher concentration of Papanicolaou test uptake among wealthier groups. In urban areas, the Cn was 0.34 (p < 0.0001), reflecting a significant concentration among the rich. However, in rural areas, the Cn was -0.10 (p = 0.3006), suggesting no significant socioeconomic inequality. Factors such as socioeconomic status (SES), education, and age contributed to reducing inequality, explaining 62.7%, 36.0%, and 1.7% of the observed inequality, respectively. Interestingly, place of residence had a negative influence on inequality. Conclusion The uptake of Papanicolaou tests varies across different socioeconomic status levels, with a higher concentration among wealthier groups. The results enable health policymakers and researchers to tailor health intervention toward increasing public awareness, especially among women with lower levels of education women in economically deprived groups.
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spelling doaj.art-1032240555374116a6c92bc8d8d2d8ed2024-03-05T20:35:36ZengBMCBMC Public Health1471-24582024-02-0124111010.1186/s12889-024-17927-xSocioeconomic disparities in Papanicolaou test utilization in Western IranBahare Safari-Faramani0Roya Safari-Faramani1Farid Najafi2Davoud Khorasani Zavareh3Ali Kazemi Karyani4Mitra Darbandi5Students Research Committee, Kermanshah University of Medical SciencesSocial Development and Health Promotion Research Center, Research Institute for Health, Kermanshah University of Medical SciencesSocial Development and Health Promotion Research Center, Research Institute for Health, Kermanshah University of Medical SciencesDepartment of Health in Emergencies and Disasters, Workplace Health Promotion Research Center (WHPRC), School of Public Health and Safety, Shahid Beheshti University of Medical SciencesResearch Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical SciencesResearch Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical SciencesAbstract Background Cervical cancer remains the fourth most frequently diagnosed cancer among women, and its impact is particularly significant in women residing in less developed countries. This study aims to assess socioeconomic inequality in using Papanicolaou tests, commonly known as Pap tests, which are crucial for detecting cervical cancer. The research also seeks to decompose this inequality, identifying its contributing factors. This investigation is conducted within a sizable population-based study focused on the Kurdish population, with an additional examination of potential variations between urban and rural areas. Method The study utilized baseline data from the Ravansar Non-Communicable Disease Cohort Study (RaNCD), involving 3,074 ever-married women aged 35–65. Asset data was employed to determine socioeconomic status (SES), and Principal Component Analysis was applied. The uptake of Papanicolaou tests was assessed for inequality using the Concentration Index (Cn). Additionally, decomposition analysis was conducted to identify and understand the factors contributing to socioeconomic inequality. Results The study found that overall, 86% of women reported having undergone cervical cancer screening at least once in their lifetime. The Concentration Index (Cn) for the total population was 0.21 (p < 0.0001), indicating a higher concentration of Papanicolaou test uptake among wealthier groups. In urban areas, the Cn was 0.34 (p < 0.0001), reflecting a significant concentration among the rich. However, in rural areas, the Cn was -0.10 (p = 0.3006), suggesting no significant socioeconomic inequality. Factors such as socioeconomic status (SES), education, and age contributed to reducing inequality, explaining 62.7%, 36.0%, and 1.7% of the observed inequality, respectively. Interestingly, place of residence had a negative influence on inequality. Conclusion The uptake of Papanicolaou tests varies across different socioeconomic status levels, with a higher concentration among wealthier groups. The results enable health policymakers and researchers to tailor health intervention toward increasing public awareness, especially among women with lower levels of education women in economically deprived groups.https://doi.org/10.1186/s12889-024-17927-xCervical cancerInequalityIranPapanicolaou testSocioeconomic status
spellingShingle Bahare Safari-Faramani
Roya Safari-Faramani
Farid Najafi
Davoud Khorasani Zavareh
Ali Kazemi Karyani
Mitra Darbandi
Socioeconomic disparities in Papanicolaou test utilization in Western Iran
BMC Public Health
Cervical cancer
Inequality
Iran
Papanicolaou test
Socioeconomic status
title Socioeconomic disparities in Papanicolaou test utilization in Western Iran
title_full Socioeconomic disparities in Papanicolaou test utilization in Western Iran
title_fullStr Socioeconomic disparities in Papanicolaou test utilization in Western Iran
title_full_unstemmed Socioeconomic disparities in Papanicolaou test utilization in Western Iran
title_short Socioeconomic disparities in Papanicolaou test utilization in Western Iran
title_sort socioeconomic disparities in papanicolaou test utilization in western iran
topic Cervical cancer
Inequality
Iran
Papanicolaou test
Socioeconomic status
url https://doi.org/10.1186/s12889-024-17927-x
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