Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/25518
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dc.contributor.authorMassat, Nathalie Jen_UK
dc.contributor.authorDouglas, Elaineen_UK
dc.contributor.authorWaller, Joen_UK
dc.contributor.authorWardle, Janeen_UK
dc.contributor.authorDuffy, Stephen Wen_UK
dc.date.accessioned2018-01-20T00:50:02Z-
dc.date.available2018-01-20T00:50:02Z-
dc.date.issued2015-07-01en_UK
dc.identifier.urihttp://hdl.handle.net/1893/25518-
dc.description.abstractObjectives: Reducing cancer screening inequalities in England is a major focus of the 2011 Department of Health cancer outcome strategy. Screening coverage requires regular monitoring in order to implement targeted interventions where coverage is low. This study aimed to characterise districts with atypical coverage levels for cervical or breast screening.  Design: Observational study of district-level coverage in the English Cervical and Breast screening programmes in 2012.  Setting: England, UK.  Participants: All English women invited to participate in the cervical (age group 25-49 and 50-64) and breast (age group 50-64) screening programmes.  Outcomes: Risk adjustment models for coverage were developed based on district-level characteristics. Funnel plots of adjusted coverage were constructed, and atypical districts examined by correlation analysis.  Results: Variability in coverage was primarily explained by population factors, whereas general practice characteristics had little independent effect. Deprivation and ethnicity other than white, Asian, black or mixed were independently associated with poorer coverage in both screening programmes, with ethnicity having the strongest effect; by comparison, the influence of Asian, black or mixed ethnic minority was limited. Deprivation, ethnicity and urbanisation largely accounted for the lower cervical screening coverage in London. However, for breast screening, being located in London remained a strong negative predictor. A subset of districts was identified as having atypical coverage across programmes. Correlates of deprivation in districts with relatively low adjusted coverage were substantially different from overall correlates of deprivation.  Discussion: These results inform the continuing drive to reduce avoidable cancer deaths in England, and encourage implementation of targeted interventions in communities residing in districts identified as having atypically low coverage. Sequential implementation to monitor the impact of local interventions would help accrue evidence on 'what works'.en_UK
dc.language.isoenen_UK
dc.publisherBMJ Publishing Groupen_UK
dc.relationMassat NJ, Douglas E, Waller J, Wardle J & Duffy SW (2015) Variation in cervical and breast cancer screening coverage in England: A cross-sectional analysis to characterise districts with atypical behaviour. BMJ Open, 5 (7). https://doi.org/10.1136/bmjopen-2015-007735en_UK
dc.rightsThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/en_UK
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en_UK
dc.titleVariation in cervical and breast cancer screening coverage in England: A cross-sectional analysis to characterise districts with atypical behaviouren_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1136/bmjopen-2015-007735en_UK
dc.identifier.pmid26209119en_UK
dc.citation.jtitleBMJ Openen_UK
dc.citation.issn2044-6055en_UK
dc.citation.volume5en_UK
dc.citation.issue7en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.citation.date24/07/2015en_UK
dc.contributor.affiliationQueen Mary, University of Londonen_UK
dc.contributor.affiliationEconomicsen_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.contributor.affiliationUniversity College Londonen_UK
dc.contributor.affiliationQueen Mary, University of Londonen_UK
dc.identifier.isiWOS:000363482000041en_UK
dc.identifier.scopusid2-s2.0-84941556214en_UK
dc.identifier.wtid526473en_UK
dc.contributor.orcid0000-0001-8540-1126en_UK
dc.date.accepted2015-06-08en_UK
dcterms.dateAccepted2015-06-08en_UK
dc.date.filedepositdate2017-06-22en_UK
rioxxterms.apcnot requireden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorMassat, Nathalie J|en_UK
local.rioxx.authorDouglas, Elaine|0000-0001-8540-1126en_UK
local.rioxx.authorWaller, Jo|en_UK
local.rioxx.authorWardle, Jane|en_UK
local.rioxx.authorDuffy, Stephen W|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2017-06-22en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by-nc/4.0/|2017-06-22|en_UK
local.rioxx.filenameMassat_etal_BMJOpen_2015.pdfen_UK
local.rioxx.filecount1en_UK
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