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Élodie Guillaume, Rémy De Mil, Marie Christine Quertier

    Sante Publique (Vandoeuvre-Les-Nancy, France)
    |June 20, 2022
    PubMed
    Summary

    Targeted interventions can reduce cancer screening inequalities. Adding social worker support for colorectal cancer screening and mobile mammography services effectively addressed social and territorial disparities.

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    Area of Science:

    • Public Health
    • Health Equity
    • Social Determinants of Health

    Context:

    • Social inequalities significantly hinder national social and economic cohesion, particularly within the healthcare sector.
    • Cancer screening participation exhibits a pronounced social gradient and substantial territorial disparities.
    • Existing national screening programs often fail to reach specific populations, exacerbating health inequities.

    Purpose:

    • To evaluate the effectiveness of additional interventions aimed at reducing social and territorial inequalities in cancer screening.
    • To assess the impact of social worker assistance in colorectal cancer screening (Prado trial).
    • To analyze the outcomes of mobile mammography services (mammobile) in addressing screening access.

    Summary:

    • Two interventional studies were conducted: a prospective trial (April 2011-April 2013) in Northern France involving social workers for colorectal cancer screening and a retrospective analysis of mobile mammography in Orne.
    • Both interventions demonstrated a capacity to reduce or eliminate social and territorial inequalities in cancer screening.
    • The principle of proportionate universalism, which involves tailored additional support for specific populations, is crucial for reducing screening disparities.

    Impact:

    • These targeted approaches can significantly improve health equity by reducing disparities in cancer screening participation.
    • Implementing additional, population-specific screening initiatives alongside national programs is essential for achieving equitable health outcomes.
    • The findings suggest that addressing social and territorial inequalities in screening is feasible at a reasonable societal cost.

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