General practitioners may improve cervical screening equality in France.

Area of Science:

• Public Health
• Healthcare Policy
• Gynecology

Background:

• Vulnerable populations face challenges in accessing quality healthcare.
• Primary care-focused health systems show potential for improved effectiveness, efficiency, and equity.
• Persistent barriers to accessing primary care necessitate targeted interventions.

Purpose of the Study:

• To investigate the characteristics of women undergoing Cervico-Uterine Smear (CUS) for cervical cancer screening.
• To analyze CUS screening patterns based on the type of healthcare professional (general practitioners vs. gynecologists).
• To identify socioeconomic and geographical disparities in access to cervical cancer screening.

Main Methods:

• Retrospective observational study utilizing French health insurance data.
• Analysis of 695,694 women aged 25-64 in 2012 eligible for CUS.
• Multinomial logistic regression examining sociodemographic (age, deprivation) and territorial (healthcare proximity) indicators.

Main Results:

• 202,271 (29%) women underwent CUS; 68% by gynecologists, 28% by general practitioners (GPs).
• Screening rates decreased with increased age, rural location, deprivation, and sparse healthcare provision.
• Deprived populations appeared less disadvantaged when screened by GPs.

Conclusions:

• General Practitioners' involvement in CUS screening may enhance cervical screening equality in France.
• Organizing health systems around primary care can improve access and address needs of deprived populations.
• Primary care integration is crucial for equitable cervical cancer prevention strategies.