Socioeconomic inequalities in cervical cancer screening practices in Vietnam: a decomposition analysis

In Vietnam, cervical cancer remains a critical public health issue, with disparities in screening uptake reflecting broader socioeconomic inequalities.

This study aims to dissect socioeconomic disparities in cervical cancer screening uptake among Vietnamese women, using data from the 2020-2021 Multiple Indicator Cluster Survey 6 (MICS).

Employing a cross-sectional design, we analysed MICS Survey data for women's cervical cancer screening reports over the past three years. The study utilised decomposition analysis to unravel the contributions of various determinants to socioeconomic disparities in screening uptake, employing Poisson regression with robust variance models to explore the association between socioeconomic status, quantified through Wealth Index quintiles, and screening practices.

Among participants, 28.2% reported receiving cervical cancer screening. The positive Erreygers concentration index value (ECI) was overall 0.296, which was statistically significant at a 1% level, indicating that cervical cancer screening was predominantly concentrated among individuals with higher wealth index scores. Decomposition analysis indicated that ethnic minority status significantly contributed to this disparity, alongside factors such as education and residency.

The use of the concentration index in this study elucidates significant socioeconomic and ethnic inequalities in cervical cancer screening in Vietnam. It underlines the necessity of tailored interventions aimed at the most disadvantaged groups, including ethnic minorities and low-income populations, to mitigate these disparities. Strategic policy reforms and targeted health initiatives are essential for promoting equitable access to cervical cancer screening and improving public health outcomes across Vietnam.