Individual and contextual socio-sanitary factors associated with preventive practices of breast and cervical cancer in women in Argentina, 2018
In Argentina, breast and cervical cancers are the most common cancers in women. At the national level, geographic disparities were described related to the use of preventive practices for these cancers, particularly mammography and Papanicolaou (PAP). Objective: To analyze the association of individ...
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| Autores principales: | , , , , , , |
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/36682 |
| Aporte de: |
| Sumario: | In Argentina, breast and cervical cancers are the most common cancers in women. At the national level, geographic disparities were described related to the use of preventive practices for these cancers, particularly mammography and Papanicolaou (PAP). Objective: To analyze the association of individual socio-demographic characteristics and socio-sanitary contextual factors with the use of these practices in women in Argentina (2018).
An observational-analytical cross-sectional study was carried out using the 2018 National Survey of Risk Factors (Ministry of Health) as a secondary data source (multi-stage probabilistic sample). A sub-sample was extracted, including women whose ages were in the target groups for mammograms (50-70 years; n=4,924) and PAP (25-65 years; n=11,576). Data on these preventive practices (done in the last 2 years, yes/no) and on sociodemographic characteristics (age, income quintile, level of education, health coverage, type of household, place of residence according to population size) were included. At the contextual level, three-year averages (2016-2018) were calculated for the maternal mortality ratio (MMR) and for the total number of doctors (per 1000 inhabitants), by province. Measures of association (OR) of these individual and contextual variables were estimated for each preventive practice (dichotomous response) using multilevel logistic models, with a random intercept (provinces) and a random coefficient (for context variables).
Both preventive practices were significantly associated with higher levels of education and income and showed an inverse association with age (OR 0.95 and 0.98 for mammograms and PAP, respectively; p <0.001). A higher chance of having PAP/mammograms was estimated in those that reside in cities with 150,000 or more inhabitants (vs. <150,000), and in those with medical insurance (vs. only public medical coverage; OR 2.24 for mammography and 1.66 for PAP; p<0.001). The chance was significantly lower in women from single-parent households with children or other members vs. single-person households (OR 0.64 for mammograms; p=0.001). The total number of physicians and MMR showed a direct and inverse association, respectively, with both practices (p<0.05).
Concluding, the cervical and breast cancer preventive practices studied were associated with underlying socio-demographic and contextual factors related to women's health care in Argentina, showing noticeable social inequities. |
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