Abstract：
OBJECTIVE:To analyze the association between travel time and participation in a breast cancer screening program adjusted for contextual variables in the province of Segovia (Spain). METHODS:We performed an ecological study using the following data sources: the Breast Cancer Early Detection Program of the Primary Care Management of Segovia, the Population and Housing Census for 2001 and the municipal register for 2006-2007. The study period comprised January 2006 to December 2007. Dependent variables consisted of the municipal participation rate and the desired level of municipal participation (greater than or equal to 70%). The key independent variable was travel time from the municipality to the mammography unit. Covariables consisted of the municipalities' demographic and socioeconomic factors. We performed univariate and multivariate Poisson regression analyses of the participation rate, and logistic regression of the desired participation level. RESULTS:The sample was composed of 178 municipalities. The mean participation rate was 75.2%. The desired level of participation (≥ 70%) was achieved in 119 municipalities (67%). In the multivariate Poisson and logistic regression analyses, longer travel time was associated with a lower participation rate and with lower participation after adjustment was made for geographic density, age, socioeconomic status and dependency ratio, with a relative risk index of 0.88 (95% CI: 0.81-0.96) and an odds ratio of 0.22 (95% CI: 0.1-0.47), respectively. CONCLUSION:Travel time to the mammography unit may help to explain participation in breast cancer screening programs.
journal_name
Gac Sanitjournal_title
Gaceta sanitariaauthors
Borda A,Sanz B,Otero L,Blasco T,García-Gómez FJ,de Andrés Fdoi
10.1016/j.gaceta.2010.10.010subject
Has Abstractpub_date
2011-03-01 00:00:00pages
151-6issue
2eissn
0213-9111issn
1578-1283pii
S0213-9111(10)00295-5journal_volume
25pub_type
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