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e-Article

Role of mammography accessibility, deprivation and spatial effect in breast cancer screening participation in France: an observational ecological study
Document Type
article
Source
International Journal of Health Geographics. 21(1)
Subject
Health Services and Systems
Public Health
Health Sciences
Prevention
Cancer
Health Services
Clinical Research
Breast Cancer
Humans
Female
Breast Neoplasms
Early Detection of Cancer
Mammography
Geography
France
Health Services Accessibility
Breast cancer screening
Spatial accessibility
Spillover effect
Deprivation
Spatial autoregressive models
Public Health and Health Services
Human Geography
Epidemiology
Health services and systems
Public health
Language
Abstract
BackgroundThe detection of cancer in its early latent stages can improve patients' chances of recovery and thereby reduce the overall burden of the disease. Our objectives were to investigate factors (geographic accessibility and deprivation level) affecting mammography screening participation variation and to determine how much geographic variation in participation rates can be explained by spillover effects between adjacent areas, while controlling for covariates.MethodsMammography screening participation rates between 2015 and 2016 were calculated by census blocks (CB), for women aged 50-74 years, residing in Lyon metropolitan area. Global spatial autocorrelation tests were applied to identify the geographic variation of participation. Spatial regression models were used to incorporate spatial structure to estimate associations between mammography participation rate and the combined effect (geographic accessibility and deprivation level) adjusting for modes of travel and social cohesion.ResultsThe mammography participation rate was found to have a statistically significant and positive spatial correlation. The participation rate of one CB was significantly and positively associated with the participation rates of neighbouring CB. The participation was 53.2% in residential and rural areas and 46.6% in urban areas, p