Les déterminants du recours au dépistage du cancer du col de l’utérus : une analyse départementale

Abstract

The goal of this study is to analyse the drivers of geographic disparities in cervical cancer screening in France. The studied sample consisted of women aged?25?to?65?enrolled in the statutory health insurance scheme (and possibly the complementary scheme) with MGEN, a French non-for-profit health insurance institution ( ?mutuelle?), from?1 January?2012?to?31?December?2014. Multilevel models confirm territorial inequalities in cervical cancer screening. Moreover, they show that age, the cost of gynecological appointment, and residence in a deprived area are all associated with a decrease of the likelihood of being screened. On the contrary, living in a couple, coverage by statutory and complementary health insurance, medical monitoring for contraception or pregnancy, being screened for breast cancer, and the density of health professionals are associated with increased cervical cancer screening uptake. Different policy levers are discussed in relation to the major role played by health professionals in screening access.