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Guthmuller S, Carrieri V, Wübker A. Effects of organized screening programs on breast cancer screening, incidence, and mortality in Europe. JOURNAL OF HEALTH ECONOMICS 2023; 92:102803. [PMID: 37688931 DOI: 10.1016/j.jhealeco.2023.102803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/11/2023]
Abstract
We link data on regional Organized Screening Programs (OSPs) throughout Europe with survey data and population-based cancer registries to estimate effects of OSPs on breast cancer screening (mammography), incidence, and mortality. Identification is from regional variation in the existence and timing of OSPs, and in their age-eligibility criteria. We estimate that OSPs, on average, increase mammography by 25 percentage points, increase breast cancer incidence by 16% five years after the OSPs implementation, and reduce breast cancer mortality by about 10% ten years after.
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Affiliation(s)
- Sophie Guthmuller
- Health Economics and Policy group, Department of Socioeconomics, Vienna University of Economics and Business, Welthandelsplatz 1, Building D4 1020 Vienna, Austria; RWI-Leibniz Institute for Economic Research, Hohenzollernstr. 1-3 45128 Essen, Germany; European Commission, Joint Research Centre, Ispra, VA, Italy.
| | - Vincenzo Carrieri
- RWI-Leibniz Institute for Economic Research, Hohenzollernstr. 1-3 45128 Essen, Germany; Department of Political and Social Sciences, University of Calabria 87036, Rende, Italy; Forschungsinstitut zur Zukunft der Arbeit (IZA), Schaumburg-Lippe-Straße 5-9 53113 Bonn, Germany
| | - Ansgar Wübker
- RWI-Leibniz Institute for Economic Research, Hohenzollernstr. 1-3 45128 Essen, Germany; Hochschule Harz, Friedrichstraße 57-59 38855 Wernigerode, Germany
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Portero de la Cruz S, Béjar LM, Cebrino J. Temporal Evolution and Associated Factors of Adherence to Mammography Screening among Women in Spain: Results from Two National Health Surveys (2017-2020). Healthcare (Basel) 2023; 11:2934. [PMID: 37998426 PMCID: PMC10671473 DOI: 10.3390/healthcare11222934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Ensuring equity in cancer screening is recommended by the European Commission. Despite the fact that breast cancer screening is a free population-based program in Spain, there remains considerable variation in the adherence to screening rate among population groups. This study was designed to describe the adherence of breast cancer screening in women in Spain, to evaluate the evolution in the period from 2017 to 2020, and to determine the variables that influence choosing to undergo breast cancer screening. A nationwide cross-sectional study with 7220 females aged 50-69 years from the 2017 Spanish National Health Survey and the 2020 European Health Survey for Spain was performed. We investigated mammography uptake rates, with socio-demographic factors, lifestyle habits, and health-related characteristics as independent variables. Multivariable logistic regression was used to identify the associated factors of mammography adherence. Of the women, 78% had undergone mammography in the previous two years, and there was a significant decrease in the uptake rate for breast cancer screening from 2017 (81.23%) to 2020 (74.68%) (p < 0.001). Educational level, marital status, residential location, nationality, smoking status, alcohol consumption, and leisure-time physical activity were all associated factors of mammography uptake.
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Affiliation(s)
- Silvia Portero de la Cruz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba, Avda. Menéndez Pidal, S/N, 14071 Córdoba, Spain
- Research Group GE10 Clinical and Epidemiological Research in Primary Care, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, 14071 Córdoba, Spain
| | - Luis M. Béjar
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Seville, Avda. Doctor Fedriani, S/N, 41009 Seville, Spain; (L.M.B.); (J.C.)
| | - Jesús Cebrino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Seville, Avda. Doctor Fedriani, S/N, 41009 Seville, Spain; (L.M.B.); (J.C.)
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Zhang X, Li P, Zhang C, Guo P, Wang J, Liu N, Yang S, Yu L, Zhang W. Breast Cancer Screening Practices and Satisfaction With Healthcare Providers in Chinese Women: A Cross-sectional Study. Cancer Nurs 2021; 45:E573-E581. [PMID: 33813526 DOI: 10.1097/ncc.0000000000000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Chinese government has proposed cancer screening guidelines and launched 2 cancer screening programs to improve screening practices. However, the screening participation rates of Chinese women remain low. Exploring the factors affecting breast cancer screening to promote cancer screening is necessary. OBJECTIVE The aim of this study was to investigate women's satisfaction with healthcare providers and screening practices. METHODS A cross-sectional survey was conducted from November 2019 to April 2020 in Changchun, Jilin Province, China. The Medical Care Satisfaction Scale and SERVQUAL were used to quantify women's satisfaction with doctors and nurses, respectively. RESULTS Women's satisfaction with doctors (68.81 ± 11.08; range, 20-100) and with nurses (87.64 ± 16.17; range, 22-110) was moderate. Compared with women who had not participated in screening within the past 2 years, screened women reported higher satisfaction with doctors (P = .026) and nurses (P = .012). Older age (P = .004) was an independent predictor of women's satisfaction with doctors. Similarly, women's education level (P = .049), chronic disease history (P = .029), and physical examination history (P = .039) were 3 independent predictors of women's satisfaction with nurses. CONCLUSIONS Future intervention strategies can not only increase the screening rates by providing existing intervention methods but also improve women's satisfaction with healthcare providers to promote screening practices. IMPLICATIONS FOR PRACTICE This article provides a theoretical basis for healthcare providers to increase female screening practices. It also provides references for improving existing intervention methods.
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Affiliation(s)
- Xuehui Zhang
- Author Affiliations: Nursing School, Jilin University (Mss X Zhang, Guo, Wang, Liu, Yang, and Yu, and Dr W Zhang); and the Second Hospital of Jilin University (Dr Li and Ms C Zhang), Changchun, China
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Alshammari SA, Alhazmi AM, Alenazi HA, Alshammari HS, Alshahrani AM. Mammography uptake among the female staff of King Saud University. J Family Med Prim Care 2020; 9:221-228. [PMID: 32110594 PMCID: PMC7014892 DOI: 10.4103/jfmpc.jfmpc_706_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/07/2019] [Accepted: 12/05/2019] [Indexed: 11/23/2022] Open
Abstract
Background: Breast cancer is having a major impact on women's health worldwide. Early detection is the best defense against the associated morbidity and mortality of the disease. Objectives: To assess the level of mammography uptake among working Saudi women and identify the obstacles and barriers that negatively affect it. In addition, to identify the most effective sources of breast-cancer-related information and early detection screening. Method: We conducted a cross-sectional study of women employees of King Saud University aged 40 years and above on March–May 2015 using a self-report questionnaire. Results: A total of 229 participants were recruited from the female staff of King Saud University. Of the participants, 34% were aged 41 years or above, approximately 66% were married, 53.3% had a bachelor's degree, and 61.1% worked as administrators; further, 64.6% had a history of breastfeeding. The rate of mammography uptake was 51.5%. Univariate logistic regression indicated that age, education, and being single predict the rate of mammography uptake. However, multivariate logistic regression indicated that earlier age significantly predicts a higher risk of a low rate of mammography uptake. The main obstacle negatively affecting mammography uptake was ineligible criteria (21.8%). The main sources of information regarding breast cancer were awareness campaigns and television and radio (45.4% and 43.7%, respectively). Conclusion: The participants' rate of mammography uptake, awareness of mammograms, the risk factors, and signs of breast cancer were low. To improve breast-cancer mortality rates in Saudi Arabia, earlier detection of breast cancer through increasing awareness of mammograms is of paramount importance.
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Affiliation(s)
- Sulaiman Abdullah Alshammari
- Health Promotion and Health Education Research Chair, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali Mohsen Alhazmi
- Health Promotion and Health Education Research Chair, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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MEREU A, CONCU F, DESSÌ C, GIRAU M, IONTA M, LAI L, LIORI A, MASALA M, MCGILLIARD C, ORIGA P, PIAZZA M, PISANU L, SOGGIU B, SOTGIU A, CONTU P, SARDU C. Knowledge about cancer screening programmes in Sardinia. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E337-E342. [PMID: 31967090 PMCID: PMC6953453 DOI: 10.15167/2421-4248/jpmh2019.60.4.1094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 10/16/2019] [Indexed: 11/26/2022]
Abstract
Background High level of attendance by population is considered a proof of the efficacy in the screening programmes. Public health aims to increase people’s attendance to cancer screening. The study aimed at assessing the level of knowledge and awareness about screening of citizens in Cagliari, from June to July 2016. Methods Recruitment took place near the atrium of the two main shopping centres of the city. The sample included 270 adults (138 men), 18-75 years old (mean age 46 years old). The information gathered from interviews were categorized by dichotomizing answers according to the knowledge and understanding of the discussed topics. Descriptive analysis was performed. The Chi-square test was used to assess gender and educational differences. Results Results show that population’s knowledge of screening is limited. Although the word “screening” is known, only half of the people who declared to have heard of this word know about the aim of screening. Colorectal cancer screening is the least known. Men and people with lower education are less informed than women and those with high education level. Conclusion In order to raise knowledge and awareness about cancer screening, special attention should be paid to communication and to the use of plain language. Future action should highlight the benefit of the screening procedure and thus contributing to spread the cancer prevention culture. Gender and socioeconomic inequalities must be taken into account when planning screening communication campaigns. General practitioner are highly trusted by people. They could play a decisive role to promote screening attendance.
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Affiliation(s)
- A. MEREU
- Department of Medical Science and Public Health, University of Cagliari, Italy
- Correspondence: Alessandra Mereu, Department of Medicine Science and Public Health, University of Cagliari, Cittadella Universitaria di Monserrato - SS554 (Bivio Sestu) - 09042 Monserrato (CA), Italy - Tel. +39 070 6753103 - E-mail:
| | - F. CONCU
- Medicine and Surgery Faculty, University of Cagliari, Italy
| | - C. DESSÌ
- Specialization School of Hygiene and Preventive Medicine, University of Cagliari, Italy
| | - M. GIRAU
- Specialization School of Hygiene and Preventive Medicine, University of Cagliari, Italy
| | - M.T. IONTA
- Oncology Structure of University Hospital of Cagliari, Italy
| | - L. LAI
- Specialization School of Hygiene and Preventive Medicine, University of Cagliari, Italy
| | - A. LIORI
- Specialization School of Hygiene and Preventive Medicine, University of Cagliari, Italy
| | - M. MASALA
- Medicine and Surgery Faculty, University of Cagliari, Italy
| | - C.D. MCGILLIARD
- Specialization School of Hygiene and Preventive Medicine, University of Cagliari, Italy
| | - P. ORIGA
- Department of Medical Science and Public Health, University of Cagliari, Italy
| | - M.F. PIAZZA
- Medicine and Surgery Faculty, University of Cagliari, Italy
| | - L. PISANU
- Specialization School of Hygiene and Preventive Medicine, University of Cagliari, Italy
| | - B. SOGGIU
- Specialization School of Hygiene and Preventive Medicine, University of Cagliari, Italy
| | - A. SOTGIU
- Department of Medical Science and Public Health, University of Cagliari, Italy
| | - P. CONTU
- Department of Medical Science and Public Health, University of Cagliari, Italy
| | - C. SARDU
- Department of Medical Science and Public Health, University of Cagliari, Italy
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