Organized screening programmes for breast and cervical cancer in 17 EU countries: trajectories of attendance rates

The aim was to analyse participation trajectories in organised breast and cervical cancer screening programmes and the association between socioeconomic variables and participation. A pooled, cross-sectional, time series analysis was used to evaluate secondary data from 17 European countries in 2004–2014. The results show that the mammographic screening trend decreases after an initial increase (coefficient for the linear term = 0.40; p = 0.210; 95% CI = − 0.25, 1.06; coefficient for the quadratic term = − 0.07; p = 0.027; 95% CI = − 0.14, − 0.01), while the cervical screening trend is essentially stable (coefficient for the linear term = 0.39, p = 0.312, 95% CI = − 0.42, 1.20; coefficient for the quadratic term = 0.02, p = 0.689, 95% CI = − 0.07, 0.10). There is a significant difference among the country-specific slopes for breast and cervical cancer screening (SD = 16.7, p < 0.001; SD = 14.4, p < 0.001, respectively). No association is found between participation rate and educational level, income, type of employment, unemployment and preventive expenditure. However, participation in cervical cancer screening is significantly associated with a higher proportion of younger women (≤ 49 years) and a higher Gini index (that is, higher income inequality). In conclusion three messages: organized cancer screening programmes may reduce the socioeconomic inequalities in younger people’s use of preventive services over time; socioeconomic variables are not related to participation rates; these rates do not reach a level of stability in several countries. Therefore, without effective recruitment strategies and tailored organizations, screening participation may not achieve additional gains.