Socioeconomic status & returning for a second screen in the Ontario breast screening program

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Organized breast cancer screening programs aim for regular participation.
• Understanding factors influencing re-attendance is crucial for program effectiveness.
• Geographically derived socioeconomic status (SES) is a potential determinant of screening behavior.

Purpose of the Study:

• To examine the relationship between SES and return for a second mammography screen.
• To investigate the modifying effect of rurality on the SES-screening relationship.

Main Methods:

• Retrospective cohort study of 57,902 women screened by the Ontario Breast Screening Program (OBSP).
• Analysis controlled for age, rurality, language, initial mammography results, prior history, and referral.
• Geographically derived SES was categorized into quintiles.

Main Results:

• Socioeconomic status (SES) was associated with re-attendance for screening.
• Rurality significantly modified the relationship between SES and re-attendance.
• Urban women in the lowest SES quintiles were less likely to return for screening compared to the highest quintile; this effect was not observed in rural women.

Conclusions:

• Lower socioeconomic status (SES) is linked to reduced re-attendance in urban breast cancer screening settings.
• Targeted interventions for low SES urban women are recommended to improve screening adherence.
• Rurality plays a key role in the SES-screening re-attendance relationship, suggesting context-specific strategies are needed.