{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:49:01Z","timestamp":1792511341794,"version":"4.5.0"},"reference-count":33,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Despite organized screening programs, persistent social inequalities undermine cervical cancer screening effectiveness in high-income countries, disproportionately affecting the most socially vulnerable women.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To identify distinct social vulnerability profiles among pregnant women and examine their associations with cervical cancer screening adherence and intraepithelial lesion detection.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study assessed all pregnant women 25 years or older who delivered at Centre Hospitalier Intercommunal Andr\u00e9-Gr\u00e9goire, a single tertiary care maternity unit in France, between May 1, 2019, and May 1, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Social vulnerability was assessed across 15 indicators spanning administrative, psychological, and violence-related domains. Multiple component analysis and hierarchical clustering on principal components identified 6 distinct vulnerability profiles. Multiple logistic regression examined associations between profiles and cervical screening inadequacy (no cervical sample within the last 3 years, including those never screened) and squamous intraepithelial lesion detection, adjusting for maternal age and body mass index.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Cervical screening inadequacy (primary outcome) and low- and high-grade squamous intraepithelial lesion detection (secondary outcome).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 18\u202f253 women (median [IQR] age, 32.3 [29.1-36.0] years; median [IQR] body mass index, 25.9 [22.7-29.4]), 10\u202f248 (56.1%) were up to date with screening. Six vulnerability profiles were identified. Compared with the low-vulnerability reference profile, all profiles showed increased odds of screening inadequacy: substance use and psychological vulnerability (adjusted odds ratio [AOR], 1.33; 95% CI, 1.20-1.48), migrant or linguistic barrier (AOR, 3.40; 95% CI, 3.16-3.66), psychological violence (AOR, 2.01; 95% CI, 1.75-2.32), sexual violence (AOR, 2.08; 95% CI, 1.74-2.48), and physical violence (AOR, 2.54; 95% CI, 2.19-2.95). Violence-exposed and substance use profiles also had significantly higher proportions of women with a detected intraepithelial lesion despite reduced screening participation.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of pregnant women, distinct social vulnerability profiles were differentially associated with cervical cancer screening inadequacy; women with migration-related barriers experienced the greatest disadvantage, and violence-exposed women showed both reduced screening and elevated disease burden. These findings suggest profile-specific interventions could help reduce cervical cancer screening inequalities among socially vulnerable populations.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.39570","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:30:21Z","timestamp":1792510221000},"page":"e2639570","source":"Crossref","is-referenced-by-count":0,"title":["Multiple Dimensions of Social Vulnerability and Cervical Cancer Screening Uptake"],"prefix":"10.1001","volume":"9","author":[{"given":"Julie","family":"Haury","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Intercommunal Hospital Center Andr\u00e9 Gr\u00e9goire, Montreuil, France"},{"name":"Department of Surgery and Oncological Gynecology, Piti\u00e9-Salp\u00eatri\u00e8re University Hospital, Paris, France"},{"name":"University Institute of Cancerology, Assistance Publique-H\u00f4pitaux de Paris, Sorbonne University, Paris, France"},{"name":"Saint-Antoine Research Center, INSERM UMR_S_938, Cancer Biology and Therapeutics, Sorbonne University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Baptiste","family":"Chanier","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Intercommunal Hospital Center Andr\u00e9 Gr\u00e9goire, Montreuil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Renevier","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Intercommunal Hospital Center Andr\u00e9 Gr\u00e9goire, Montreuil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffroy","family":"Canlorbe","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncological Gynecology, Piti\u00e9-Salp\u00eatri\u00e8re University Hospital, Paris, France"},{"name":"University Institute of Cancerology, Assistance Publique-H\u00f4pitaux de 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