ArticleInternational journal for equity in health2023
Social determinants influencing cervical cancer diagnosis: an ecological study.
Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 15 citations in OpenAlex.
- Demographic and social determinants of human immunodeficiency virus status among women with cervical cancer in a low-resource setting.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2026Article
- Primary and secondary prevention of cervical cancer during the COVID-19 pandemic in Sao Paulo State, Brazil.Revista do Instituto de Medicina Tropical de Sao Paulo · 2026Article
- Medicaid expansion and overall mortality among women with cervical cancer.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Childcare Barriers and Appointment Nonadherence Among Women in a Safety-Net Health System.JAMA network open · 2025Article
- Acute toxicity profile and treatment response of image guided hybrid brachytherapy using Venezia applicators in locally advanced cervical cancer: a single-centre experience in Pakistan.Ecancermedicalscience · 2025Article
- Time series and risk factors associated with mortality in women with cervical cancer from 2000 to 2021.Gynecologic oncology reports · 2024Article
- Socioeconomic and cultural factors associated with pap smear screening among French women living in Réunion Island.BMC public health · 2024Article
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Authors and funding
6 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundBarriers to accessing health care result in advanced cervical cancer. In Sao Paulo, Brazil, the Index of Social Responsibility (ISR) synthesizes the situation of each town concerning wealth, education, and longevity. This study aimed to evaluate in 645 municipalities the relation of the ISR with stage, age, and morphology in cervical cancer diagnosis.
methodsAn ecological study that used data from Sao Paulo, Brazil, from 2010 to 2017. The ISR was identified through government platforms and data on cancer through the Hospital Cancer Registry. The subjects were the 9,095 women aged 30 years or older. The ISR summarizes municipalities into five levels: dynamic (ISR5), unequal (ISR4), equitable (ISR3), in transition (ISR2), and vulnerable (ISR1). It was used the chi
resultsThe proportion of stage 1 increased significantly with ISR level, ranging from 24.9% in ISR1 to 30.0% in ISR5 (p = 0.040). To every increase in ISR level, the chance of a woman being diagnosed in stage I was at least 30% higher. Woman living where ISR2 had a 1.4 times higher chance of being diagnosed in stage 1 than those living in ISR1 (OR 1.40, 95% CI 1.07-1.84). Squamous tumors frequency decreased when ISR level increased (p = 0.117). A higher proportion of women under 50 years were observed when they lived in wealthier cities (ISR4 and ISR5) (42.2% vs. 44.6%, p = 0.016).
conclusionThe ISR was a good health indicator for understanding and predicting the social determinants in cervical cancer diagnosis. The proportion of stage I increased significantly in more favorable social conditions.
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