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Master Thesis

Accès aux soins et dépistage du cancer du col de l'utérus en population guadeloupéenne

Abstract : Introduction: Despite universal health coverage, substantial social inequalities in cancer screening remain in France. Our objective was to assess, in a French Caribbean population, if the relation between cervical cancer screening and access to the referring physician or to a gynecologist vary according to the social position of users. Methods: A multicenter cross-sectional study was retrospectively conducted, including all women aged 25-64 who had received a periodic health examination funded by social security in Guadeloupe between January 2012 and May 2015. Use of pap smear in the last three years and access to the referring physician or to a gynecologist in the last twelve months were investigated by questionnaire. The education level defined social position. Statistical analyses used multilevel logistic regression, with search for interaction. Results: Among the 7747 complete records, 73.6% of women reported having achieved a pap smear in the last three years. All things being equal, the OR of cancer screening in relation to access to the referring physician was estimated at 2.7 (p<0.001) in women with at least a middle school diploma, against 1.3 (p=0.069) in those with less education. Corresponding values in relation to access to a gynecologist were 5.0 and 3.2, respectively (p<0.001). The modifying effect of education level was significant. Conclusions: In this population with good access to care, the relation between medical follow up and cervical cancer screening was impaired among disadvantaged women. Greater involvement of professionals and better support to users are required to reduce screening inequalities
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https://dumas.ccsd.cnrs.fr/dumas-01412057
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Submitted on : Wednesday, December 7, 2016 - 7:30:58 PM
Last modification on : Monday, July 20, 2020 - 6:46:02 PM
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Jean-Baptiste Azaïs. Accès aux soins et dépistage du cancer du col de l'utérus en population guadeloupéenne. Sciences du Vivant [q-bio]. 2016. ⟨dumas-01412057⟩

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