• Edige Felipe de Sousa Santos, Camila Nascimento Monteiro, Diama Bhadra Vale, Marília Louvison, Moisés Goldbaum, Chester Luiz Galvão Cesar, and Marilisa Berti de Azevedo Barros.
• Faculdade de Saúde Pública, Universidade de São Paulo (USP), São Paulo, SP, Brazil. Electronic address: edige@usp.br.
• Clinics (Sao Paulo). 2023 Jan 1; 78: 100160100160.

ObjectiveThis study monitors trends in access to cancer screening, focusing on mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA), assessing the magnitude of inequality in the city of São Paulo from 2003 to 2015 according to education level.MethodThis is a cross-sectional population-based study conducted with data from the 2003, 2008, and 2015 editions of the Health Survey of the City of São Paulo (ISA-Capital). Outcome variables were the proportion of mammography, Papanicolaou (Pap smear), and Prostate-Specific Antigen (PSA) tests according to the protocols. Inequality was measured by education level according to years of study. For static analysis, Poisson regression was used to estimate proportion ratios.ResultsThe proportion of Pap smears remained stationary at a high level (>89%) throughout the study period, while access to mammography and PSA tests significantly increased in the 2003‒2015 period. The present results indicate inequalities in access to cancer screening due to education, and being more expressive for mammography and PSA tests. However, this inequality significantly decreased over the period analyzed comparing the most educated individuals with those with the lowest educational level. In addition, an increase in the proportion of tests performed in the Brazilian Unified Health System was identified, especially for mammography and PSA tests, in the period 2003‒2015.ConclusionsThe inequalities observed in the access to preventive exams were influenced by the level of education. The offer of exams was expanded, more significantly for mammography and PSA, especially among the less educated group.Copyright © 2022 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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