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After introduction of a primary care–based national quality indicator program in Israel, socioeconomic disparities in breast and colorectal cancer screening rates among women decreased, while cervical cancer screening rates and disparities remained largely unchanged. Breast cancer screening rates increased from 67.4% in 2002 to 70.5% in 2017, the highest among the three cancers examined. Screening rates for colorectal cancer also increased, from 56.7% in 2002 to 64.3% in 2017. In contrast, cervical cancer screening rates increased only slightly, from 48.5% in 2002 to 49.6% in 2017. Disparities in screening rates between women of high and low socioeconomic status, as measured by both individual and area-level indicators, decreased for breast and colorectal cancer following introduction of quality indicators for these screenings in 2004 and 2005, respectively. However, socioeconomic disparities in cervical cancer screening persisted, with screening rates more than 3 times higher among women of high versus low socioeconomic status. The more recent introduction of a quality indicator for cervical cancer screening in 2015 has not yet led to meaningful changes. These findings suggest that national quality indicator programs emphasizing the role of primary care physicians can increase cancer screening rates and reduce disparities, but effects may take time to manifest and depend on the specific screenings targeted.

Primary care physicians play an important role in encouraging cancer screening.After introduction of quality indicators, breast and colorectal cancer screening rates increased in Israel, with greater reductions in socioeconomic disparities.

Published By:

Y. L. Weisband - Annals of Family Medicine

2021

Cited By:

6