[Gynaecologic follow up, physicians involved and cervical smears: An accumulation of social disparities]

This study analysed how social disparities are built in the health process leading to the achievement of cervical smears.

A cross-sectional study included women over 40 years eligible for cervical cancer screening and recruited randomly in the patient base of 52 volunteer general practitioners (GP). Judgement criteria were (1) the existence of a gynaecological follow up, (2) provided by a GP (versus gynaecologist), and (3) the "up to date" status for the cervical smear. Occupational class, education, and perceived financial condition evaluated social position.

Among 1092 women (participation 74%), 86% had a gynaecological follow up. It was associated with a higher social position and to more "up to date" status. The follow up was performed by the GP for 10% of the patients who mainly had a lower social position. The "up to date" status was more prevalent when the follow up was done by the gynaecologist than by a GP but was socially differentiated.

Having a gynaecological follow up, especially by a gynaecologist, improved cervical screening but social inequalities were linked to its achievement at every part of this process.