Uptake in breast cancer screening: A sociogeographical analysis

During the period 1992 to 1994, the female population aged 40to 69 years old and living in Gent, Belgium, was invited througha personal letter to participate in a breast cancer screeningprogramme. The women were asked to consult a physician beforereferral to a local radiologist. After six months, a reminderletter was sent. The eligible population amounted to 40,713women. Of these, 22.5% were recorded to have attended for ascreening mammography. The uptake levels were analysed per statisticalsector, which is a more or less homogeneous quarter in socialrespect. The age-standardized participation ranged from 6 to42% among the 150 sectors taken into account. The participationwas definitely highest in well-to-do neighbourhoods and lowestin the poorer inner-city quarters. In a multivariate analysis,social exclusion indicators such as percentage of persons onwelfare and percentage of unoccupied dwellings ranked first.On condition that this social gradient is confirmed on an individualbasis, sociogeographical analysis may well be a powerful toolin area-based health promotion campaigns.