Highlights
- •The adherence rate for mammography was below the recommended 70 % in 2017.
- •This percentage adherence rate for mammography had decreased from 2011.
- •The figures for cervical cancer screening were over 70 % and stable over time.
- •Negative factors predicting adherence to screening included non-healthy lifestyle behaviors.
- •Immigrant women had a lower uptake of both tests than did Spanish-born women.
Abstract
Objectives
To analyze the uptake of breast and cervical cancer screening according to the 2017
Spanish National Health Survey (SNHS), to compare uptake rates with those obtained
in the previous SNHS 2011 and to identify predictors for the uptake for these two
screening tests.
Study design
Cross-sectional study.
Main outcome measures
Uptake rates of breast cancer and cervical cancer screening were analyzed for women
aged 40–69 and aged 25–65 years, respectively. Independent variables included sociodemographic
characteristics and factors related to health status and lifestyle.
Results
We found that 66.8 % of women aged 40–69 years had undergone mammography in the previous
two years. Positive predictors for mammography uptake were age (50–69 years); marital
status (married); Spanish nationality; university education; one or more chronic diseases;
no alcohol consumption; physical activity; body mass index <30 kg/m2; and not smoking. We observed that 73.0 % of women aged 25–65 years had undergone
cervical cytology screening in the previous three years. Positive predictors for uptake
were age (25–52 years); marital status (married); Spanish nationality; middle-high
educational level; no chronic diseases; no alcohol consumption; physical activity;
body mass index <30 kg/m2; and not smoking. There was a significant decrease in the uptake rate for breast
cancer screening from the previous SNHS 2011 (OR 0.89; 95 % CI 0.83–0.94).
Conclusions
The adherence rate for mammography in Spain in 2017 was below the recommended 70 %
and was significantly lower than in 2011. The figures for cervical cancer screening
were over 70 % and stable over time.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA Cancer J. Clin. 2018; 68: 394-424
Ministerio de Sanidad y Consumo The National Health System Cancer Strategy Madrid Actualizacion 2010. Madrid, Spain. http://www.msps.es/organizacion/sns/planCalidadSNS/pdf/ActualizacionEstrategiaCancer.pdf.
- Breast and cervical cancer screening in Spain and predictors of adherence.Eur. J. Cancer Prev. 2010; 19: 239-245
- Burden of cervical cancer in Europe: estimates for 2004.Ann. Oncol. 2007; 18: 1708-1715
Instituto Nacional de Estadística. Encuesta Nacional de Salud 2011–2012. http://www.ine.es/jaxi/menu.do?type=pcaxis&path=/t15/p419&file=inebase&L=0.
US. Preventive Services Task Force (USPSTF) http://www.uspreventiveservicestaskforce.org/uspstopics.htm#A-Z.
- Council Recommendation of 2 December on Cancer Screening.Off J Eur Union, 2003: 34-38 (878)
- Effect of population breast screening on breast cancer mortality up to 2005 in England and Wales: an individual-level cohort study.Br. J. Cancer. 2017; 116: 246-252
- Patterns and trends in human papillomavirus‐related diseases in central and eastern Europe and central Asia.Vaccine. 2013; 31: 32-45
- Social disparities in access to breast and cervical cancer screening by women living in Spain.Public Health. 2015; 129: 881-888
- Methodology of SNHS 2017.Instituto Nacional de Estadística, Spain. Madrid2019
- The National Health System Cancer Strategy. Actualization 2010.Ministry of Health and Consumption, Madrid2012
- Mammographic breast density by area of residence: possible evidence of higher density in urban areas.Curr. Med. Res. Opin. 2008; 24: 365-368
- Crisis económica y salud en España.Ministerio de Sanidad, Consumo y Bienestar Social, 2018
- Cervical cancer screening policies and coverage in Europe.Eur. J. Cancer. 2009; 45: 2649-2658
- Use of pap smear for cervical cancer screening and factors related with its use in Spain.Aten. Primaria. 2004; 33: 229-234
- Trend in cervical cancer screening in Spain (2003-2009) and predictors of adherence.Eur. J. Cancer Prev. 2012; 21: 82-88
- Social disparities in breast and cervical cancer preventive practices.Eur. J. Cancer Prev. 2007; 16: 372-379
- Guía de cribado del cáncer de cuello de utero en España, 2014.Rev. Esp. Patol. 2014; 47: 1-43
- Cervical cancer screening among young adult women in the United States.Cancer Epidemiol. Biomarkers Prev. 2013; 22: 580-588
- Prevalence in the performance of mammographies in Spain: analysis by Communities 2006–2014 and influencing factors.Aten. Primaria. 2017; https://doi.org/10.1016/j.aprim.2017.03.007.27
- A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demo-graphics and decision-making style.BMC Public Health. 2017; 17: 327
- The global burden of women’s cancers: a grand challenge in global health.Lancet. 2017; 389: 847-860
- Cancer screening practices and associated lifestyles in population controls of the Spanish multi-case control study.Gac. Sanit. 2012; 26: 301-310
- Does heightening risk appraisals change people’s intentions and behavior? A meta-analysis of experimental studies.Psychol. Bull. 2014; 140: 511-543
- Screening for cervical and breast cancer. Is obesity an unrecognized barrier to preventive care?.Ann. Intern. Med. 2000; 132: 697-704
- Management of weight problems and obesity: knowledge, attitudes, and current practice of general practitioners.Br. J. Gen. Pract. 1991; 41: 147-150
- The association of obesity and cervical cancer screening: a systematic review and meta-analysis.Obesity (Silver Spring). 2009; 17: 375-381
- Tailored interventions to promote mammography screening: a meta-analytic review.Prev. Med. 2007; 45: 252-261
- Factors influencing colorectal cancer screening participation.Gastroenterol. Res. Pract. 2012; 2012483417
Article info
Publication history
Published online: February 24, 2020
Accepted:
February 23,
2020
Received in revised form:
December 23,
2019
Received:
October 4,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
