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Published on: March 13, 2011
Cervical screening by socio-economic status in Australia
R J Taylor1, H A Mamoon, S L Morrell
1NSW Cervical Screening Program, Westmead Hospital, New South Wales, Australia.
Australian and New Zealand Journal of Public Health
|August 10, 2001
Summary
Women with lower socioeconomic status (SES) in Australia are less likely to undergo Pap testing. Individual SES measures better capture these screening disparities than area-based measures.
Area of Science:
- Public Health
- Epidemiology
- Health Services Research
Background:
- Cervical cancer screening through Pap tests is crucial for early detection.
- Socioeconomic status (SES) is a known determinant of health behaviors, including cancer screening.
- Understanding SES differentials in Pap test rates is vital for targeted public health interventions.
Purpose of the Study:
- To analyze trends and disparities in self-reported Pap test rates based on socioeconomic status (SES) in Australia.
- To compare the effectiveness of individual versus area-based SES measures in identifying Pap test screening inequalities.
- To quantify the contribution of low SES to under-screening for Pap tests.
Main Methods:
- Utilized unit record data from the 1989/90 and 1995 Australian National Health Surveys (NHS).
- Defined outcome as self-reported Pap test within the past three years.
- Employed logistic regression, controlling for migrant status, rurality, survey year, and age, with SES measured by individual characteristics and area of residence.
Main Results:
- Higher individual SES was significantly associated with increased odds of Pap test reporting.
- Women with no post-school qualifications (OR=0.86), low income (<$20,000, OR=0.79), blue-collar (OR=0.84), and unemployed (OR=0.73) status showed significantly lower Pap test rates.
- Individual SES measures revealed larger disparities in Pap test rates compared to area-based measures.
Conclusions:
- Significant socioeconomic gradients exist in Pap test screening behavior in Australia.
- Individual-level SES assessment provides a more accurate picture of screening inequalities than ecological measures.
- Low individual SES accounts for approximately 25% of under-screening, compared to 8% when SES is measured ecologically.
