AUTHOR=Audiger Céline , Bovagnet Thomas , Bardes Julia , Abihsera Gaëlle , Nicolet Jérôme  , Deghaye Michel , Bochaton Audrey , Menvielle Gwenn 

TITLE=Social Inequalities in Participation in Cervical Cancer Screening in a Metropolitan Area Implementing a Pilot Organised Screening Programme (Paris Region, France)

JOURNAL=International Journal of Public Health

VOLUME=Volume 67 - 2022

YEAR=2022

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2022.1604562

DOI=10.3389/ijph.2022.1604562

ISSN=1661-8564

ABSTRACT=Objectives
We aimed to examine social inequalities in participation in CCS in a metropolitan area implementing a pilot organised screening programme. The pilot programme consisted in sending invitations to women who did not perform a pap smear within the past three years, managing interventions to reach vulnerable women, training healthcare professionals and setting up the follow-up of abnormal pap smears.
Methods
We studied participation in CCS between January 2014 and December 2016 among 241,257 women aged 25-63 y.o. To assess relative inequalities, Odds Ratios were computed using a multilevel logistic regression. To assess absolute inequalities, the CCS coverage and the rate difference were calculated. Inequalities were computed by age and neighbourhood characteristics (social deprivation and proportion of single women). 
Results
Disparities in participation in CCS were observed by age and social deprivation. For overall screening compared to opportunistic screening disparities by age were larger (OR25-35_vs_55-64=2.13[2.08-2.19] compared to 2.02[1.96-2.07]), but disparities by social deprivation were decreased (OR10%_most_vs_10%_least_deprived=2.09[1.90-2.30] compared to 2.22[2.02-2.44]).
Conclusion
Disparities in CCS participation remain despite the organised programme. To reduce these inequalities, free screening should be proposed and evaluated.