Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological study
Abstract Background The detection of cancer in its early latent stages can improve patients’ chances of recovery and thereby reduce the overall burden of the disease. Our objectives were to investigate factors (geographic accessibility and deprivation level) affecting mammography screening participa...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | International Journal of Health Geographics |
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| Online Access: | https://doi.org/10.1186/s12942-022-00320-5 |
| _version_ | 1797977294929657856 |
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| author | Nirmala Prajapati Patricia Soler-Michel Verónica M. Vieira Cindy M. Padilla |
| author_facet | Nirmala Prajapati Patricia Soler-Michel Verónica M. Vieira Cindy M. Padilla |
| author_sort | Nirmala Prajapati |
| collection | DOAJ |
| description | Abstract Background The detection of cancer in its early latent stages can improve patients’ chances of recovery and thereby reduce the overall burden of the disease. Our objectives were to investigate factors (geographic accessibility and deprivation level) affecting mammography screening participation variation and to determine how much geographic variation in participation rates can be explained by spillover effects between adjacent areas, while controlling for covariates. Methods Mammography screening participation rates between 2015 and 2016 were calculated by census blocks (CB), for women aged 50–74 years, residing in Lyon metropolitan area. Global spatial autocorrelation tests were applied to identify the geographic variation of participation. Spatial regression models were used to incorporate spatial structure to estimate associations between mammography participation rate and the combined effect (geographic accessibility and deprivation level) adjusting for modes of travel and social cohesion. Results The mammography participation rate was found to have a statistically significant and positive spatial correlation. The participation rate of one CB was significantly and positively associated with the participation rates of neighbouring CB. The participation was 53.2% in residential and rural areas and 46.6% in urban areas, p < 0.001. Using Spatial Lag models, whereas the population living in most deprived CBs have statistically significantly lower mammography participation rates than lower deprived ones, significant interaction demonstrates that the relation differs according to the degree of urbanization. Conclusions This study makes an important methodological contribution in measuring geographical access and understanding better the combined effect of deprivation and the degree of urbanization on mammography participation and other contextual factors that affect the decision of using mammography screening services -which is a critical component of healthcare planning and equity. |
| first_indexed | 2024-04-11T05:04:36Z |
| format | Article |
| id | doaj.art-c8f23cfab3ed409e87fad36d79309a33 |
| institution | Directory Open Access Journal |
| issn | 1476-072X |
| language | English |
| last_indexed | 2024-04-11T05:04:36Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Health Geographics |
| spelling | doaj.art-c8f23cfab3ed409e87fad36d79309a332022-12-25T12:27:59ZengBMCInternational Journal of Health Geographics1476-072X2022-12-0121111010.1186/s12942-022-00320-5Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological studyNirmala Prajapati0Patricia Soler-Michel1Verónica M. Vieira2Cindy M. Padilla3Univ Rennes, EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS-U 1309Centre Régional de Coordination des Dépistages des Cancers Auvergne Rhône AlpesDepartment of Environmental and Occupational Health, Program in Public Health, University of CaliforniaUniv Rennes, EHESP, CNRS, Inserm, Arènes-UMR 6051, RSMS-U 1309Abstract Background The detection of cancer in its early latent stages can improve patients’ chances of recovery and thereby reduce the overall burden of the disease. Our objectives were to investigate factors (geographic accessibility and deprivation level) affecting mammography screening participation variation and to determine how much geographic variation in participation rates can be explained by spillover effects between adjacent areas, while controlling for covariates. Methods Mammography screening participation rates between 2015 and 2016 were calculated by census blocks (CB), for women aged 50–74 years, residing in Lyon metropolitan area. Global spatial autocorrelation tests were applied to identify the geographic variation of participation. Spatial regression models were used to incorporate spatial structure to estimate associations between mammography participation rate and the combined effect (geographic accessibility and deprivation level) adjusting for modes of travel and social cohesion. Results The mammography participation rate was found to have a statistically significant and positive spatial correlation. The participation rate of one CB was significantly and positively associated with the participation rates of neighbouring CB. The participation was 53.2% in residential and rural areas and 46.6% in urban areas, p < 0.001. Using Spatial Lag models, whereas the population living in most deprived CBs have statistically significantly lower mammography participation rates than lower deprived ones, significant interaction demonstrates that the relation differs according to the degree of urbanization. Conclusions This study makes an important methodological contribution in measuring geographical access and understanding better the combined effect of deprivation and the degree of urbanization on mammography participation and other contextual factors that affect the decision of using mammography screening services -which is a critical component of healthcare planning and equity.https://doi.org/10.1186/s12942-022-00320-5Breast cancer screeningSpatial accessibilitySpillover effectDeprivationSpatial autoregressive models |
| spellingShingle | Nirmala Prajapati Patricia Soler-Michel Verónica M. Vieira Cindy M. Padilla Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological study International Journal of Health Geographics Breast cancer screening Spatial accessibility Spillover effect Deprivation Spatial autoregressive models |
| title | Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological study |
| title_full | Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological study |
| title_fullStr | Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological study |
| title_full_unstemmed | Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological study |
| title_short | Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological study |
| title_sort | role of mammography accessibility deprivation and spatial effect in breast cancer screening participation in france an observational ecological study |
| topic | Breast cancer screening Spatial accessibility Spillover effect Deprivation Spatial autoregressive models |
| url | https://doi.org/10.1186/s12942-022-00320-5 |
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