The role of sociodemographic factors in preventive practices - The case ofcervical and breast cancer

Background: The objective of this study was to investigate the role of soci odemographic factors in the performance of periodic gynaecological visits, cervical smears and mammographies in a population of women over 29 years of age and to describe social inequalities in the use of opportunistic screen ing for breast and cervical cancer. Methods: A cross-sectional study using a representative stratified sample of the non-institutionalized population resident in Barcelona, Spain, in 1992 was performed. Included were 1,667 wo men over 29 years of age. The variables studied were periodic gynaecologica l check-up, periodic smear and periodic mammography, as well as age, marita l status, educational level, job situation and social class. Multivariate a nalysis was performed in order to determine predictive factors of gynaecolo gical preventive practices, through logistic regression models. Results: Un married women had a higher risk of not having a periodic cervical smear [od ds ratio (OR) adjusted for age, marital status, education level and job sit uation = 2.53 with 95% confidence interval (CI): 1.66-3.86] or periodic mam mography (OR=2.84 and 95% CI: 1.77-4.54), Women with a lower educational le vel followed preventive practices less often. Women who were unemployed, re tired or students had a higher risk of not having periodic smears (OR=2.14 and 95% CI: 1.45-3.18) and of not having periodic mammography (OR=1.69 and 95% CI: 1.12-2.55), Conclusions: Opportunistic screening is more susceptibl e to social inequalities than systematic screening programmes. The risk of not performing these practices increased with women's low social indicators (class and education) and age. This study has a significative relevance in the international context because it shows a population-based analysis tha t is very scarce in southern Europe and could be used for comparisons in fu ture studies of inequalities in health.