ArticleBMC health services research2018
The impact of regional screening policies on the diffusion of cancer screening participation in Belgium: time trends in educational inequalities in Flanders and Wallonia.
Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- The Effect of Peer-Led Navigation Approach as a Form of Task Shifting in Promoting Cervical Cancer Screening Knowledge, Intention, and Practices Among Urban Women in Tanzania: A Randomized Controlled Trial.Cancer control : journal of the Moffitt Cancer CenterTrial
- Reciprocal innovation to improve access to primary healthcare in Belgium: adaptation and development of a community health worker intervention.BMC health services research · 2026Article
- Linguistic difference in the effect of organized programs on socioeconomic inequalities in breast cancer screening: ecological study in Switzerland.European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) · 2025Article
- Relationship between health-related determinants and adherence to breast and colorectal cancer screening: a population-based study in Flanders, Belgium.European journal of public health · 2024Article
- Socio-economic inequality of utilization of cancer testing in Europe: A cross-sectional study.Preventive medicine reports · 2022Article
- Social Inequalities in Participation in Cervical Cancer Screening in a Metropolitan Area Implementing a Pilot Organised Screening Programme (Paris Region, France).International journal of public health · 2022Article
- Patient preferences for gene therapy in haemophilia: Results from the PAVING threshold technique survey.Haemophilia : the official journal of the World Federation of Hemophilia · 2021Article
- Cervical cancer screening programs and their context-dependent effect on inequalities in screening uptake: a dynamic interplay between public health policy and welfare state redistribution.International journal for equity in health · 2021Article
- The Role of Socio-Demographic Factors in the Coverage of Breast Cancer Screening: Insights From a Quantile Regression Analysis.Frontiers in public health · 2021Article
- Coverage determinants of breast cancer screening in Flanders: an evaluation of the past decade.International journal for equity in health · 2020Article
- Never and under cervical cancer screening in Switzerland and Belgium: trends and inequalities.BMC public health · 2020Article
- Diagnostic Accuracy of Cervical Pap Smear and Colposcopy in Detecting Premalignant and Malignant Lesions of Cervix.Indian journal of surgical oncology · 2020Article
- Variation of colorectal, breast and prostate cancer screening activity in Switzerland: Influence of insurance, policy and guidelines.PloS one · 2020Article
- Existing Health Practices in Shaping the Decision to Participate During Breast Cancer Screening Among 50-69 Years Old Women in Estonia.SAGE open nursingArticle
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2 authors.
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Abstract
backgroundWe investigate whether the extent of educational inequalities in the use of Pap smears (cervical cancer screening) and mammograms (breast cancer screening) in Belgium has changed over time in accordance with the pattern predicted by diffusion of innovation theory, as well as how the regional cancer screening policies of Flanders and Wallonia influence this pattern.
methodsData were obtained from five successive cross-sectional waves (1997-2001-2004-2008-2013) of the Belgian Health Interview Survey. Final sample sizes consisted of 8988 women aged 25-64 years for cervical cancer screening and 4194 women aged 50-69 years for breast cancer screening. We calculated absolute and relative measures of inequality, more specifically, the slope index of inequality (SII) and the relative index of inequality (RII), and their development over time.
resultsIn both Flanders and Wallonia, mammogram use increased greatly between 1997 and 2013, while Pap smear use has remained quite stable over time. Educational inequalities in cervical-cancer screening have been largely persistent over time in both regions. In contrast, educational inequalities in breast cancer screening fluctuated more between 1997 and 2013. Between 1997 and 2001, when the breast cancer screening programme was implemented in Flanders, RII reduced significantly by 45%. Inequality measures did not change significantly in Wallonia, where it is known that most women are screened opportunistically outside the programme.
conclusionsBy focussing on Belgium, this study demonstrates that regional variations in the support of a national screening programme can result in regional variations in the pattern of diffusion for cancer screening, as well as to the development of inequalities in cancer screening participation. Moreover, the findings demonstrate that high visibility and awareness of the screening programme, as was more the case in Flanders than it was in Wallonia, are required in order to reduce or eliminate educational inequalities in cancer screening participation over time. General practitioners and gynaecologists can play a decisive role in this regard.
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