Differences in Breast and Cervical Cancer Screening Rates in Jordan among Women from Different Socioeconomic Strata: Analysis of the 2012 Population-Based Household Survey


Background: The burden of breast and cervical cancer is changing over time in developing countries. Regularscreening is very important for early detection and treatment. In this study, we assessed inequalities in breastand cervical cancer screening rates in women according to household wealth status, and analyzed the potentialpredictors associated with a low cancer screening rate in Jordan. Materials and
Methods: A nationwide populationbasedcross-sectional survey collected information on different variables at the national level. All ever-marriedwomen (the phrase is used throughout the text to refer to women who had ever married) aged 15–49 years wereincluded in the survey. Analysis of breast self-examination (BSE) and clinical breast examination (CBE) at leastonce in the previous year was carried out in 11,068 women, while lifetime Pap-smear testing was carried outin 8,333 women, aged 20-49 years.
Results: Over 39% and 19% of ever-married Jordanian women reportedhaving undergone a breast examination during the previous year and Pap smear examination at least once intheir lifetime, respectively. The rate of BSE in the previous year was 31.5%, that of CBE in the previous yearwas 19.3%, and that of Pap smear examination at least once in life was 25.5%. The adjusted OR was higher forperforming BSE (aOR 1.22, 95% CI 1.04–1.43), undergoing CBE (aOR 1.31, 95% CI 1.08–1.60) and undergoingPap smear examination (aOR 2.38, 95% CI 1.92–2.93) among women in the highest wealth-index quintile ascompared to those in the lowest quintile. The concentration index was 0.11 for BSE, 0.01 for CBE, and 0.27for Pap smear examination. Women in their twenties, living in rural or the southern region of Jordan, with anelementary school education or less, who listened to the radio or read the newspaper not more than a few times ayear, and nulliparous women were less likely to undergo breast and cervical cancer screening.
Conclusions: Therates of breast and cervical cancer screening are low in Jordan. Reducing the sociodemographic and economicinequalities in breast and cervical cancer screenings requires concerted outreach activities for women livingunder socially deprived conditions.