Determinants of mammography screening participation–a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS)
<h4>Purpose</h4> We investigated the association between social inequality and participation in a mammography screening program (MSP). Since the German government offers mammography screening free of charge, any effect of social inequality on participation should be due to educational st...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534433/?tool=EBI |
| _version_ | 1811344824098357248 |
|---|---|
| author | Roman M. Pokora Matthias Büttner Andreas Schulz Alexander K. Schuster Hiltrud Merzenich Andrea Teifke Matthias Michal Karl Lackner Thomas Münzel Sylke Ruth Zeissig Philipp S. Wild Susanne Singer Daniel Wollschläger |
| author_facet | Roman M. Pokora Matthias Büttner Andreas Schulz Alexander K. Schuster Hiltrud Merzenich Andrea Teifke Matthias Michal Karl Lackner Thomas Münzel Sylke Ruth Zeissig Philipp S. Wild Susanne Singer Daniel Wollschläger |
| author_sort | Roman M. Pokora |
| collection | DOAJ |
| description | <h4>Purpose</h4> We investigated the association between social inequality and participation in a mammography screening program (MSP). Since the German government offers mammography screening free of charge, any effect of social inequality on participation should be due to educational status and not due to the financial burden. <h4>Methods</h4> The ‘Gutenberg Health Study’ is a cohort study in the Rhine-Main-region, Germany. A health check-up was performed, and questions about medical history, health behavior, including secondary prevention such as use of mammography, and social status are included. Two indicators of social inequality (equivalence income and educational status), an interaction term of these two, and different covariables were used to explore an association in different logistic regression models. <h4>Results</h4> A total of 4,681 women meeting the inclusion criteria were included. Only 6.2% never participated in the MSP. A higher income was associated with higher chances of ever participating in a mammography screening (odds ratios (OR): 1.67 per €1000; 95%CI:1.26–2.25, model 3, adjusted for age, education and an interaction term of income and education). Compared to women with a low educational status, the odds ratios for ever participating in the MSP was lower for the intermediate educational status group (OR = 0.64, 95%CI:0.45–0.91) and for the high educational status group (0.53, 95%CI:0.37–0.76). Results persisted also after controlling for relevant confounders. <h4>Conclusions</h4> Despite the absence of financial barriers for participation in the MSP, socioeconomic inequalities still influence participation. It would be interesting to examine whether the educational effect is due to an informed decision. |
| first_indexed | 2024-04-13T19:52:50Z |
| format | Article |
| id | doaj.art-8efddb365de44a0ea28466eafbca2b18 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T19:52:50Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-8efddb365de44a0ea28466eafbca2b182022-12-22T02:32:26ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011710Determinants of mammography screening participation–a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS)Roman M. PokoraMatthias BüttnerAndreas SchulzAlexander K. SchusterHiltrud MerzenichAndrea TeifkeMatthias MichalKarl LacknerThomas MünzelSylke Ruth ZeissigPhilipp S. WildSusanne SingerDaniel Wollschläger<h4>Purpose</h4> We investigated the association between social inequality and participation in a mammography screening program (MSP). Since the German government offers mammography screening free of charge, any effect of social inequality on participation should be due to educational status and not due to the financial burden. <h4>Methods</h4> The ‘Gutenberg Health Study’ is a cohort study in the Rhine-Main-region, Germany. A health check-up was performed, and questions about medical history, health behavior, including secondary prevention such as use of mammography, and social status are included. Two indicators of social inequality (equivalence income and educational status), an interaction term of these two, and different covariables were used to explore an association in different logistic regression models. <h4>Results</h4> A total of 4,681 women meeting the inclusion criteria were included. Only 6.2% never participated in the MSP. A higher income was associated with higher chances of ever participating in a mammography screening (odds ratios (OR): 1.67 per €1000; 95%CI:1.26–2.25, model 3, adjusted for age, education and an interaction term of income and education). Compared to women with a low educational status, the odds ratios for ever participating in the MSP was lower for the intermediate educational status group (OR = 0.64, 95%CI:0.45–0.91) and for the high educational status group (0.53, 95%CI:0.37–0.76). Results persisted also after controlling for relevant confounders. <h4>Conclusions</h4> Despite the absence of financial barriers for participation in the MSP, socioeconomic inequalities still influence participation. It would be interesting to examine whether the educational effect is due to an informed decision.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534433/?tool=EBI |
| spellingShingle | Roman M. Pokora Matthias Büttner Andreas Schulz Alexander K. Schuster Hiltrud Merzenich Andrea Teifke Matthias Michal Karl Lackner Thomas Münzel Sylke Ruth Zeissig Philipp S. Wild Susanne Singer Daniel Wollschläger Determinants of mammography screening participation–a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS) PLoS ONE |
| title | Determinants of mammography screening participation–a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS) |
| title_full | Determinants of mammography screening participation–a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS) |
| title_fullStr | Determinants of mammography screening participation–a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS) |
| title_full_unstemmed | Determinants of mammography screening participation–a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS) |
| title_short | Determinants of mammography screening participation–a cross-sectional analysis of the German population-based Gutenberg Health Study (GHS) |
| title_sort | determinants of mammography screening participation a cross sectional analysis of the german population based gutenberg health study ghs |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534433/?tool=EBI |
| work_keys_str_mv | AT romanmpokora determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT matthiasbuttner determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT andreasschulz determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT alexanderkschuster determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT hiltrudmerzenich determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT andreateifke determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT matthiasmichal determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT karllackner determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT thomasmunzel determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT sylkeruthzeissig determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT philippswild determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT susannesinger determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs AT danielwollschlager determinantsofmammographyscreeningparticipationacrosssectionalanalysisofthegermanpopulationbasedgutenberghealthstudyghs |