Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: A pooled decomposition analysis

Mahumud, Rashidul Alam ORCID: https://orcid.org/0000-0001-9788-1868 and Alam, Khorshed ORCID: https://orcid.org/0000-0003-2232-0745 and Keramat, Syed Afroz and Renzaho, Andre M.N. and Hossain, Md. Golam and Haque, Rezwanul and Ormsby, Gail M. and Dunn, Jeff and Gow, Jeff (2020) Wealth stratified inequalities in service utilisation of breast cancer screening across the geographical regions: A pooled decomposition analysis. Archives of Public Health, 78:32. pp. 1-12. ISSN 0778-7367

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Abstract

Background
Breast cancer is the most commonly occurring cancer among women in low-resourced countries. Reduction of its impacts is achievable with regular screening and early detection. The main aim of the study was to examine the role of wealth stratified inequality in the utilisation breast cancer screening (BCS) services and identified potential factors contribute to the observed inequalities.

Methods
A population-based cross-sectional multi-country analysis was used to study the utilisation of BCS services. Regression-based decomposition analyses were applied to examine the magnitude of the impact of inequalities on the utilisation of BCS services and to identify potential factors contributing to these outcomes. Observations from 140,974 women aged greater than or equal to 40 years were used in the analysis from 14 low-resource countries from the latest available national-level Demographic and Health Surveys (2008–09 to 2016).

Results
The population-weighted mean utilisation of BCS services was low at 15.41% (95% CI: 15.22, 15.60), varying from 80.82% in European countries to 25.26% in South American countries, 16.95% in North American countries, 15.06% in Asia and 13.84% in African countries. Women with higher socioeconomic status (SES) had higher utilisation of BCS services (15%) than those with lower SES (9%). A high degree of inequality in accessing and the use of BCS services existed in all study countries across geographical areas. Older women, access to limited mass media communication, being insured, rurality and low wealth score were found to be significantly associated with lower utilisation of BCS services. Together they explained approximately 60% in the total inequality in utilisation of BCS services.

Conclusions
The level of wealth relates to the inequality in accessing BCS amongst reproductive women in these 14 low-resource countries. The findings may assist policymakers to develop risk-pooling financial mechanisms and design strategies to increase community awareness of BCS services. These strategies may contribute to reducing inequalities associated with achieving higher rates of the utilisation of BCS services.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Historic - Faculty of Business, Education, Law and Arts - School of Commerce (1 Jul 2013 - 17 Jan 2021)
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Heritage and Culture (1 Aug 2018 -)
Date Deposited: 11 Sep 2020 01:39
Last Modified: 11 Sep 2020 03:16
Uncontrolled Keywords: Breast cancer screening, Decomposition analysis, Low-resource countries, Inequality
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified
14 Economics > 1402 Applied Economics > 140208 Health Economics
11 Medical and Health Sciences > 1103 Clinical Sciences > 110311 Medical Genetics (excl. Cancer Genetics)
Socio-Economic Objectives (2008): C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified
Identification Number or DOI: https://doi.org/10.1186/s13690-020-00410-5
URI: http://eprints.usq.edu.au/id/eprint/39511

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