Wealth 'boosts breast test rate'

Wealthier women are the most likely to take up breast screening, but ethnicity not money affects the decision to have a cervical smear, a study finds.

Office of National Statistics data shows home and car-owning British women are more than twice as likely to have had a mammogram than those who rent.

But wealth does not appear to influence smears, Oxford researchers found.

They write in the BMJ that white women are more than twice as likely to have had one than women from minorities.

The researchers commissioned the Office of National Statistics to ask more than 3,000 women aged between 40 and 74 whether they had ever had a mammogram or cervical smear to detect cancer and, if so, the date of the last screening.

They said they were pleased to find 84% of the eligible women had undergone both, and only 3% had never had either.

However they did find that women who lived in households with cars and owned their own homes were more likely to have had a mammogram.

The more cars, the greater the difference, with women who owned two or more cars more than two and a half times more likely to have had breast screening than those who had none.

Breast screening is routinely offered to all women aged 50-70 in England, Wales and Scotland every three years.

Educated difference

Cervical screening meanwhile is offered to all those aged from 20 in Scotland and Wales and 24 in England.

"The challenge for the screening programmes is to make sure our services reach all parts of the population so we can reduce health inequalities"

Here the researchers found that household wealth did not play a part in whether screening was taken up.

While neither education, occupation or ethnicity influenced mammograms, all three appeared to be factors when it came to smears.

But ethnic background was the most significant, with white British women 2.2 times more likely to have ever had a smear than women from minority groups.

The report's lead author, Kath Moser, said it was beyond the scope of the study to speculate on the reasons for these differences.

However cervical smears were often done "opportunistically" at a local GP's surgery, she noted, when a woman might be attending for something else, whereas a mammography required an appointment at a special clinic which could be some distance away.

Professor Julietta Patnick, the head of NHS Cancer Screening Programmes, said: "The challenge for the screening programmes is to make sure our services reach all parts of the population so we can reduce health inequalities.

"On the one hand we need to look at where mammography is available to make it easy for women to get to their appointments without having to travel too far; while with cervical screening, we need to ensure we're providing information in an accessible way so all women can make informed decisions about whether or not to take up their invitation."

Dr Alexis Willett, Head of Policy at Breakthrough Breast Cancer, said: "This interesting study highlights the need for greater collection of information about who is attending breast screening.

"We need to better understand how to reach those who are currently not attending and encourage them to go to their appointments."

Catherine Foot, a senior fellow at the King's Fund, said the study was the "first clear evidence" of national inequalities in cancer screening.

"It's very helpful indeed to start to build up a picture of the extent of this. There are programmes already underway to address inequality but there is a lot of variation - a report like this adds fuel to the fire and emphasises the need for action."

RELATED INTERNET LINKS
British Medical Journal
NHS Cancer Screening Programmes
Cancer Research UK
The BBC is not responsible for the content of external internet sites