The varying influence of socioeconomic deprivation on breast cancer screening uptake in London


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Ruth H Jack1, Tony Robson2, Elizabeth A Davies1
1King's College London, London, UK, 2London Quality Assurance Reference Centre, London, UK

Background

Breast cancer screening uptake is a measure of who attends a screening appointment after receiving an invitation as part of the national breast screening programme. Uptake has been shown to be lower in areas with higher socioeconomic deprivation. This study aimed to examine this association for women invited to their ‘first call' (a first invite to the routine national screening programme) appointment in London, overall and for separate screening areas and ethnic groups.

Method

Data on women aged 50-52 who had a first call invitation between 31/03/2006 and 31/12/2009 in London were obtained from the London Quality Assurance Reference Centre. Based on postcode of residence, each woman was assigned to a socioeconomic deprivation quintile from the income domain of the Indices of Deprivation 2007. Logistic regression was used to assess screening uptake in socioeconomic groups overall, in different screening areas and in ethnic groups.

Results

Breast cancer screening uptake decreased with increasing socioeconomic deprivation (adjusted odds ratio (OR)=0.97, p<0.001). This pattern was also found in White British (OR=0.94, p<0.001), Black African (OR=0.89, p=0.046) and White Irish (OR=0.89, p=0.055) ethnic groups, and in South East London (OR=0.90, p<0.001) and South West London (OR=0.94, p<0.001) screening areas. In the West of London screening area uptake increased with increasing deprivation (OR=1.05, p=0.002).

Conclusion

While overall there is lower uptake of breast screening in more deprived areas, this does not apply to all individual screening areas or ethnic groups. Private screening may be influencing uptake in some areas, while the low proportions of some ethnic groups living in more affluent areas may explain the lack of association between uptake and socioeconomic deprivation.