Link between the referring physician and breast and cervical cancers screening: a cross-sectional study in France

BMC Primary Care

Research

Vladimir Druel¹  Lisa Ouanhnon¹  Marie-Eve Rouge Bugat¹  Cyrille Delpierre²  Pascale Grosclaude³ 

[1] Département Universitaire de Médecine Générale, Université Toulouse 3 Paul Sabatier, 37 allées Jules Guesde, 31000, Toulouse, France;Equity Team : Labelled By the French League Against Cancer, UMR 1295 CERPOP, Inserm, Université Toulouse III, Toulouse, France;Equity Team : Labelled By the French League Against Cancer, UMR 1295 CERPOP, Inserm, Université Toulouse III, Toulouse, France;Equity Team : Labelled By the French League Against Cancer, UMR 1295 CERPOP, Inserm, Université Toulouse III, Toulouse, France;Institut Claudius Regaud, IUCT-O, Registre Des Cancers du Tarn, F-31059, Toulouse, France;

关键词: General practitioners;    Continuity of patient care;    Early detection of cancer;    Uterine cervical neoplasms;    Breast neoplasms;    Socioeconomic factors;   

DOI  :  10.1186/s12875-023-02122-5

 received in 2023-03-03, accepted in 2023-08-03,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe aims of the “médecin traitant” or referring physician (RP) reform, introduced in France in 2004, were to improve the organisation and quality of care and to allow for greater equity, particularly in terms of prevention. The objective of our study was to evaluate the effect of having a declared RP on the uptake of screening for breast and cervical cancers, and to explore the mechanisms involved.MethodsWe used an existing dataset of 1,072,289 women, which combines data from the Health Insurance information systems, with census data. We built multivariable logistic regression models to study the effect of having a RP on the uptake of mammography and pap smear, adjusted for age, socio-economic level, health status and healthcare provision. We secondarily added to this model the variable “having consulted a General Practitioner (GP) within the year”. Finally, we evaluated the interaction between the effect of having a referring physician and the area of residence (metropolitan/urban/rural).ResultsPatients who had a declared RP had a significantly higher uptake of mammography and pap smear than those who did not. The strength of the association was particularly important in very urban areas. The effect of having visited a GP seemed to explain a part of the correlation between having a RP and uptake of screening.ConclusionsLower rates of gynaecological screening among women without an RP compared to those with an RP may partly reflect a specific behaviour pattern in women less adherent to the health care system. However, this result also shows the importance of the RP, who assumes the key role of relaying public health information in a more personalised and adapted way.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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