Does socio-economic status in Greece affect participation in cancer screening programmes during the period of financial crisis?

ᅟ: Primary health care reflects a country’s health level in relation to the current social and economic conditions according to the Declaration of Alma Ata (1978). Secondary prevention activities (Pap smear test, mammogram) promote public health through the early diagnosis of a disease. Since 2011 in Greece, due to the financial crisis, a significant reduction of national public health funding has occurred, along with substantial annual family income suppression and an increasing use of public health services. Aim: To investigate the socio-economic features of women participating in secondary prevention of breast and cervical cancer in an austerity setting. Method: Cross-sectional study in 225 women through an anonymous self-administered questionnaire in the outpatient clinic of a large anti-cancer hospital in Athens. Results: The majority of participants (56.9%) are unemployed and 24.1% declare no income. The main reason for choosing a state hospital is purely financial (55.1%). Women with higher educational level are 1.85 times more likely to get regular Pap smear tests (p = 0.026) compared to less educated women, and they also have the highest percentage (85.1%) of getting regular mammograms. Conclusion: The financial crisis is complex and several factors affect all levels of the health system. Greece has no organised population-based screening programme. Mean annual income and education level determine participation in cancer screening in women visiting a major state anticancer hospital. Moreover, reduced public health spending in a prolonged austerity setting will hinder the participation of unemployed and less educated women in regular preventive activities, thus breaching the human right to access to health prevention.