Doctoral thesis
OA Policy
English

Inequalities in cancer screening participation: A sociological approach at the crossroads of individual and contextual determinants

Imprimatur date2022-10-12
Defense date2022-09-06
Abstract

Breast, cervical and colorectal cancer screening are implemented as population-based preventive measures in many countries. Namely, these are offered to all asymptomatic individuals in target populations by doctors or screening programmes, following screening guidelines. Inequalities in cancer screening participation were reported across and within European countries. This dissertation examines how individual and contextual factors shape screening inequalities, as opposed to previous studies which have focused on individual-level determinants. Results show that not only socioeconomic status, but also social support has a direct effect on screening participation. Importantly, this effect varies in men and women, and in contexts with screening programmes. Additionally, contextual determinants, i.e. healthcare systems, social policies and gender inequality, moderate screening participation and inequalities. It is suggested that macrolevel factors affect individuals’ resources and agency, and (re)produce screening inequalities between population (sub)groups. Tackling screening inequalities may require both upstream interventions and a focus on subgroups’ specific social conditions.

Keywords
  • Socioeconomic inequalities
  • Switzerland
  • Marital status
  • Multilevel analysis
  • Belgium
  • Europe
  • Screening programmes
  • Opportunistic screening
  • Cancer screening
  • Breast cancer
  • Cervical cancer
  • Colorectal cancer
  • Social support
  • Macrolevel determinants
  • Gender inequality
  • Healthcare system
  • Social policies
  • Population-based screening
  • Mammography
  • FOBT
  • Colonoscopy
  • Pap smear
Citation (ISO format)
JOLIDON, Vladimir Ernest. Inequalities in cancer screening participation: A sociological approach at the crossroads of individual and contextual determinants. Doctoral Thesis, 2022. doi: 10.13097/archive-ouverte/unige:165212
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Creation18/11/2022 10:59:00
First validation18/11/2022 10:59:00
Update16/03/2023 09:02:56
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