The profile of non-participating women belongs on the one hand to those in the middle or upper social classes, undergoing HRT and being screened by other health services and, on the other, to a group of women of low social class, whose reason for non-participation is fear and timetable difficulties.
Le cancer du testicule et les traitements de chimiothdrapie et de radio-th4rapie qui l'accompagnent peuvent ~tre potentiellement source de stdrilit4 chez l~omme. La conservation de sperme doit donc 6tre systdmatiquement propos4e aux patients. Nous prdsentons ici les r4sultats d'une 6tude rdtrospective men4e aupr~s de 17 CECOS. Ce travail montre une forte augmentation des indications d'autoconservation pour cancer du testicule. II analyse les modalit4s de la garde des gamAtes ainsi que leurs devenirs ~ long terrne. Au vue de ces 414ments, nous proposons une discussion sur les attitudes adoptdes par les CECOS et les principales questions qu'elles soul,vent.
Background
Breast cancer remains the most frequent tumour and first cancer related cause of death in the Valencian Community. Despite most of the population being aware of the existence of breast cancer screening programs (BCSP), there are great differences in uptake that are likely attributed to social determinants. The objective of this study, alligning with SDGs 3 and 10, is to assess inequalities in breast cancer screening uptake, diagnosis and treatment delay in the city of Valencia.
Methods
The population of study included 128 123 women invited to participate in the BCSP in the city of Valencia between 2014 and 2016. Uptake, diagnosis and treatment delay were assessed as outcomes. Covariates included country of origin, education level, size of family unit, risk of vulnerability, age, presence of disability, assigned health department and a social deprivation index. Bivariate analysis and logistic regression models were performed for each independent variable.
Results
BCSP uptake was of 63,8% with a diagnostic rate of 5,36‰. 76,7% of patients were below the 75th percentile of delay between diagnosis and treatment (52 days). Statistically significant relationships were found between uptake of BCSP and all studied covariates both in the bivariate analysis and regression model. Presence of disability, family unit size, age and health department had a statistically significant relationship with diagnosis in the bivariate analysis, of which only one health department and the social deprivation index’s second quintile remained significant in the regression model. No significant relations were found between treatment delay and any of the covariates.
Conclusions
Strong inequalities in the BCSP have been identified. Influencing factors must be targeted so as to ensure an egalitarian access to BCSP. Given its multifactorial nature, simple analyses must be avoided in the study of inequalities in breast cancer diagnosis. Data on lifestyle may contribute to future models.
Key messages
Social determinants continue to have an impact in the uptake of breast cancer screening programs in the city of Valencia. The assessment of inequalities in breast cancer diagnosis cannot be approached uniquely through the analysis of social determinants and may Benefit from the inclusion of data on lifestyle choices.
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