Ethnic inequalities in the access of cancer screening services for women´s in Peru (preprint)

ABSTRACT

Background Despite guidelines and increased healthcare resources, there are disparities in coverage of screening cancer services for non-white communities, addressing these health inequalities is crucial in multicultural countries like Peru. For this reason, the aim was evaluating ethnic inequalities in the women proportion that use cancer screening services in Peruvians regions.Methods An ecological was used to assess the ethnic inequalities in the proportion of women use of general cancer screening, clinical breast examination, mammography, and pap test in the 25 regions of Peru. The inequalities were approach by estimating the GINI coefficient among ethnic groups based on various sociodemographic characteristics, and the annual variation of the GINI coefficient.Results In Peruvians regions there is greater inequality in general cancer screening services among the indigenous (GINI 0.321) and afroperuvians (GINI 0.415), which have a GINI coefficient almost twice that of the white or mestizo group (GINI 0.183). Also, sociodemographic characteristics such as low educational level, low income, living in rural areas, being over 64 years old, and lack of health insurance mediate these inequalities in the use of cancer screening services. In the temporal variation, an increase in inequality was identified to afroperuvians and indigenous groups after 2020.Conclusion In Peruvian regions there are marked ethnic inequalities in use of cancer screening services for indigenous and afroperuvians groups compared to the white or mestizo group, especially in those regions with larger populations with adverse socioeconomic conditions that have worsened for these ethnic groups after the COVID-19 pandemic in Peru.