Regional and social inequalities in mammography and Papanicolaou tests in Brazilian state capitals in 2019: a cross-sectional study

Abstract

Objective:

To assess regional and social inequalities in mammography and Papanicolaou tests.

Methods:

This was a cross-sectional study with data from the 2019 Chronic Disease Risk and Protective Factors Surveillance Telephone Survey (Vigitel). The outcome variables were mammography and cytopathology test. The exposure variables were race/skin color, schooling and region of residence in Brazil. Absolute inequality measurements were presented using the slope index of inequality (SII) and equiplots.

Results:

23,339 women were included in this study. Having a mammography was 5.2 percentage points higher in women with higher levels of education, while having a cytopathology test was 5.3 percentage points lower in women of Black race/skin color.

Having mammography and cytopathology tests was 3.9 and 11.2 percentage points higher, respectively, in the Southern region.

Conclusion:

Social and regional inequalities persist in Brazil and affect mainly women of Black race/skin color, with low education levels and living in the Northeast region of the country.

Keywords:
Mammography; Papanicolaou Test; Gynecological Examination; Socioeconomic Factors; Cross-Sectional Studies; Health Surveys.