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Cervical and breast cancer screening in Belgium : socio-economic phenomena in screening uptake and over-use

Vincent De Prez (UGent)
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Abstract
Objective Many women take Pap smears outside the three-yearly cytological screening interval and outside the 25-64-year-old recommended age-range. We approach this kind of deviation from the medical norm from a medicalization perspective. By charting the social composition of Pap smear uptakers and its evolution over time in Belgium, we aim to shed light on the social determinants of over-screening as medicalization of preventive behavior, and how these are mediated by the governmental limited-reimbursement initiative that was implemented in 2009. Methods Data from 15455 women from five waves (1997-2013) of the Belgian Health Interview Survey are used. Over-screening is operationalized as the deviation from screening recommendations in a twofold manner, namely based on the frequency of screening (3-yearly intervals), and the age of the target population (25-64). Logistic regressions are performed. Results Pap smear uptake increased from 69,5% in 1997 to 72,9% in 2013. Among the screening women, the proportion that was screened within the last year remained stable around 68% between 1997 and 2008, but declined significantly to 52,4% in 2013. Pap smear uptake is higher for women aged 30-50, having a high educational degree, and having high household income. These socioeconomic indicators are not related to over-screening. Over-screening is highest in Brussels. Conclusion The women who get over-screened constitute a shrinking proportion in a generally growing group of women who get a Pap smear. Higher educated women are more susceptible to the medicalization of their preventive behavior and show more norm compliance. The limited-reimbursement initiative was successful.

Citation

Please use this url to cite or link to this publication:

MLA
De Prez, Vincent. “Cervical and Breast Cancer Screening in Belgium : Socio-Economic Phenomena in Screening Uptake and over-Use.” Dag van de Sociologie, Abstracts, 2019.
APA
De Prez, V. (2019). Cervical and breast cancer screening in Belgium : socio-economic phenomena in screening uptake and over-use. In Dag van de sociologie, Abstracts. Amsterdam.
Chicago author-date
De Prez, Vincent. 2019. “Cervical and Breast Cancer Screening in Belgium : Socio-Economic Phenomena in Screening Uptake and over-Use.” In Dag van de Sociologie, Abstracts.
Chicago author-date (all authors)
De Prez, Vincent. 2019. “Cervical and Breast Cancer Screening in Belgium : Socio-Economic Phenomena in Screening Uptake and over-Use.” In Dag van de Sociologie, Abstracts.
Vancouver
1.
De Prez V. Cervical and breast cancer screening in Belgium : socio-economic phenomena in screening uptake and over-use. In: Dag van de sociologie, Abstracts. 2019.
IEEE
[1]
V. De Prez, “Cervical and breast cancer screening in Belgium : socio-economic phenomena in screening uptake and over-use,” in Dag van de sociologie, Abstracts, Amsterdam, 2019.
@inproceedings{8667113,
  abstract     = {Objective
Many women take Pap smears outside the three-yearly cytological screening interval and outside the 25-64-year-old recommended age-range. We approach this kind of deviation from the medical norm from a medicalization perspective. By charting the social composition of Pap smear uptakers and its evolution over time in Belgium, we aim to shed light on the social determinants of over-screening as medicalization of preventive behavior, and how these are mediated by the governmental limited-reimbursement initiative that was implemented in 2009.

Methods
Data from 15455 women from five waves (1997-2013) of the Belgian Health Interview Survey are used. Over-screening is operationalized as the deviation from screening recommendations in a twofold manner, namely based on the frequency of screening (3-yearly intervals), and the age of the target population (25-64). Logistic regressions are performed.

Results
Pap smear uptake increased from 69,5% in 1997 to 72,9% in 2013. Among the screening women, the proportion that was screened within the last year remained stable around 68% between 1997 and 2008, but declined significantly to 52,4% in 2013. Pap smear uptake is higher for women aged 30-50, having a high educational degree, and having high household income. These socioeconomic indicators are not related to over-screening. Over-screening is highest in Brussels.

Conclusion
The women who get over-screened constitute a shrinking proportion in a generally growing group of women who get a Pap smear. Higher educated women are more susceptible to the medicalization of their preventive behavior and show more norm compliance. The limited-reimbursement initiative was successful.},
  author       = {De Prez, Vincent},
  booktitle    = {Dag van de sociologie, Abstracts},
  language     = {eng},
  location     = {Amsterdam},
  title        = {Cervical and breast cancer screening in Belgium : socio-economic phenomena in screening uptake and over-use},
  year         = {2019},
}