UPTAKE IN BREAST-CANCER SCREENING - A SOCIOGEOGRAPHICAL ANALYSIS

During the period 1992 to 1994, the female population aged 40 to 69 ye ars old and living in Cent, Belgium, was invited through a personal le tter to participate in a breast cancer screening programme. The women were asked to consult a physician before referral to a local radiologi st. After six months, a reminder letter was sent. The eligible populat ion amounted to 40,713 women. Of these, 22.5% were recorded to have at tended for a screening mammography. The uptake levels were analysed pe r statistical sector, which is a more or less homogeneous quarter in s ocial respect. The age-standardized participation ranged from 6 to 42% among the 150 sectors taken into account. The participation was defin itely highest in well-to-do neighbourhoods and lowest in the poorer in ner-city quarters. In a multivariate analysis, social exclusion indica tors such as percentage of persons on welfare and percentage of unoccu pied dwellings ranked first. On condition that this social gradient is confirmed on an individual basis, sociogeographical analysis may well be a powerful tool in area-based health promotion campaigns.