Socioeconomic inequalities in breast and cervical screening coverage in England: are we closing the gap?

J Med Screen. 2016 Jun;23(2):98-103. doi: 10.1177/0969141315600192. Epub 2015 Sep 16.


Objective: Health policy in the UK is committed to tackling inequalities in cancer screening participation. We examined whether socioeconomic inequalities in breast and cervical cancer screening participation in England have reduced over five years.

Methods: Cross-sectional analyses compared cervical and breast screening coverage between 2007/8 and 2012/13 in Primary Care Trusts (PCTs) in England in relation to area-level income deprivation.

Results: At the start and the end of this five year period, there were socioeconomic inequalities in screening coverage for breast and cervical screening. Inequalities were highest for breast screening. Over time, the coverage gap between the highest and lowest quintiles of income deprivation significantly reduced for breast screening (from 12.3 to 8.3 percentage points), but not for cervical screening (5.3 to 4.9 percentage points).

Conclusions: Efforts to reduce screening inequalities appear to have resulted in a significant improvement in equitable delivery of breast screening, although not of cervical screening. More work is needed to understand the differences, and see whether broader lessons can be learned from the reduction of inequalities in breast screening participation.

Keywords: cancer screening; coverage; socioeconomic inequalities.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / prevention & control*
  • Cross-Sectional Studies
  • Early Detection of Cancer / statistics & numerical data*
  • Early Detection of Cancer / trends
  • England
  • Female
  • Healthcare Disparities*
  • Humans
  • Mammography / statistics & numerical data*
  • Middle Aged
  • Socioeconomic Factors
  • State Medicine
  • Uterine Cervical Neoplasms / prevention & control*
  • Vaginal Smears / statistics & numerical data*
  • Young Adult