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NTU 620 HEPI Lab
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Cancer screening
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NTU 620 HEPI Lab
Home
Team Members
Research Grant
Publications
Research Projects
AI and Machine learning
Physical-mental multimorbidity
Economics of Multimorbidity
Chronic condition in Singapore
Cost effectiveness analysis of intervention
Pay-for-performance
NHS Health checks
Health Workforce Planning Model
Quality of care in India
Other Research Projects
Minority health
Reproductive, Maternal, and Child health
Physical Activitiyes
Out-of-pocket expenditure for medicine
Disability and Multimorbidity
Innovative Health Financing
Health system performance evaluation
Multimorbidity and comorbidity
Indonesia Health system reform and JKN
User fee and patient cost sharing
Economic recession and health
Economics of Tobacco
Cancer screening
Media Coverage
Educational Program
More
Home
Team Members
Research Grant
Publications
Research Projects
AI and Machine learning
Physical-mental multimorbidity
Economics of Multimorbidity
Chronic condition in Singapore
Cost effectiveness analysis of intervention
Pay-for-performance
NHS Health checks
Health Workforce Planning Model
Quality of care in India
Other Research Projects
Minority health
Reproductive, Maternal, and Child health
Physical Activitiyes
Out-of-pocket expenditure for medicine
Disability and Multimorbidity
Innovative Health Financing
Health system performance evaluation
Multimorbidity and comorbidity
Indonesia Health system reform and JKN
User fee and patient cost sharing
Economic recession and health
Economics of Tobacco
Cancer screening
Media Coverage
Educational Program
Cancer screening
The inverse equity hypothesis: Does it apply to coverage of cancer screening in middle-income countries?
Background It is uncertain whether the inverse equity hypothesis—the idea that new health interventions are initially primarily accessed by the rich, but that inequalities narrow with diffusion to the poor—holds true for cancer screening in low and middle income countries (LMICs).This study examines the relationship between overall coverage and economic inequalities in coverage of cancer screening in four middle-income countries. Methods Secondary analyses of cross-sectional data from the WHO study on Global Ageing and Adult Health in China, Mexico, Russia and South Africa (2007–2010). Three regression-based methods were used to measure economic inequalities: (1) Adjusted OR; (2) Relative Index of Inequality (RII); and (3) Slope Index of Inequality. Results Coverage for breast cancer screening was 10.5% in South Africa, 19.3% in China, 33.8% in Russia and 43% in Mexico, and coverage for cervical cancer screening was 24% in South Africa, 27.2% in China, 63.7% in Mexico and 81.5% in Russia. Economic inequalities in screening participation were substantially lower or non-existent in countries with higher aggregate coverage, for both breast cancer screening (RII: 14.57 in South Africa, 4.90 in China, 2.01 in Mexico, 1.04 in Russia) and cervical cancer screening (RII: 3.60 in China, 2.47 in South Africa, 1.39 in Mexico, 1.12 in Russia). Conclusions Economic inequalities in breast and cervical cancer screening are low in LMICs with high screening coverage. These findings are consistent with the inverse equity hypothesis and indicate that high levels of equity in cancer screening are feasible even in countries with high income inequality.
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