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2.
Int J Public Health ; 67: 1604562, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35859669

RESUMO

Objectives: We aimed to examine social inequalities in participation in cervical cancer screening (CCS) in a metropolitan area by implementing a pilot organised screening programme. The pilot programme consisted of sending invitations to women who did not perform a pap smear within the past 3 years, managing interventions to reach vulnerable women, training healthcare professionals, and organising follow-ups of abnormal pap smears. Methods: We studied participation in CCS between January 2014 and December 2016 among 241,257 women aged 25-63 years old. To assess relative inequalities, Odds Ratios were computed using multilevel logistic regression. To assess absolute inequalities, the CCS coverage and the rate difference were calculated. Inequalities were computed by age and neighbourhood characteristics (social deprivation and proportion of single women). Results: Disparities in participation in CCS were observed by age and social deprivation. For overall screening compared to opportunistic screening, disparities by age were larger (OR25-35_vs._55-64 = 2.13 [2.08-2.19] compared to 2.02 [1.96-2.07]), but disparities by social deprivation were decreased (OR10%_most_vs._10%_least_deprived = 2.09 [1.90-2.30] compared to 2.22 [2.02-2.44]). Conclusion: Disparities in CCS participation remain despite the organised programme. To reduce these inequalities, free screening should be proposed and evaluated.


Assuntos
Detecção Precoce de Câncer , Neoplasias do Colo do Útero , Adulto , Feminino , França , Humanos , Pessoa de Meia-Idade , Paris , Fatores Socioeconômicos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle
3.
Bull Cancer ; 109(7-8): 768-779, 2022.
Artigo em Francês | MEDLINE | ID: mdl-35599171

RESUMO

Second reading is an important part of breast cancer organized screening program. Image quality control and detection of non-diagnosed cancer by first reader are the two goals of this process. In France, 6 % of all screening cancer are diagnosed by second reading, actually done on screen film. With the technologic evolution (Digital breast tomosynthesis, Artificial intelligence) and societal digitalization, this process need to evolve. After some report about organization and results for second reading in France and outside, current and future shortcomings, proposition from professionals involved in breast cancer screening are made to improve this public health program.


Assuntos
Neoplasias da Mama , Detecção Precoce de Câncer , Inteligência Artificial , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/prevenção & controle , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Mamografia/métodos , Programas de Rastreamento/métodos , Leitura
5.
Prev Med ; 153: 106831, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34624389

RESUMO

We aimed to identify the contextual factors associated with participation in the organized Cervical Cancer Screening (CCS) pilot program, which includes specific interventions to reach vulnerable women, in the Greater Paris region. Study population consisted of 231,712 women aged 25-65 years, who were not up to date to their smear test and had been invited to take part in the program from July 2014 to September 2017. Using a multilevel mixed logistic regression with random effects, we investigated the effect of grassroots interventions targeting vulnerable women, healthcare provider accessibility, social environment and municipal policy-related factors. The CCS rate was two times higher in women who had received their first invitation to the program during the study period (32·9%) compared to those who were already invited before the study period (15·3%). In both populations, there were no significant trends in participation with regards to the type of grassroots interventions, level of accessibility of healthcare services or municipal commitment to healthcare. Among women invited previously and aged above 35 increased participation was seen in neighborhoods with low proportion of single women or in less deprived neighborhoods. Our results identified groups of women who participated less in the organized CCS program and suggested that additional interventions targeting the barriers faced by vulnerable women, especially those aged 35-45 years old, are needed.


Assuntos
Detecção Precoce de Câncer , Neoplasias do Colo do Útero , Adulto , Idoso , Detecção Precoce de Câncer/métodos , Feminino , França/epidemiologia , Humanos , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Paris , Características de Residência , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle
6.
Bull Cancer ; 107(6): 623-628, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32416925
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