{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T23:44:49Z","timestamp":1789947889813,"version":"4.0.1"},"reference-count":32,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2013,6,18]]},"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study evaluated the impact of distance between women's residences and designated screening centres (DSC) on participation in the Quebec Breast Cancer Screening Programme, whether this impact varied according to the rural\u2013urban classification and the proportion of participants who used the DSC nearest to their home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Travel distance between the residence of 833\u2005856 women and the nearest DSC (n=85) was estimated. Data were obtained from administrative and screening programme databases. The analysis made use of a log-binomial regression model adjusting for age and material and social deprivation. The proportions of participants who used the DSC nearest to their residence were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to women living &lt;2.5\u2005km from a DSC, absolute decreases of 6.3% and 9.8% in participation rate were observed for distances of 50.0 to &lt;75.0\u2005km (rate ratios (RR)=0.88, 95% CI 0.86 to 0.89) and \u226575.0\u2005km (RR=0.81, 95% CI 0.79 to 0.83), respectively. The lowest participation (42%) was observed in Montreal Island. The distance at which participation started to decrease materially varied according to rural\u2013urban classification. Participation rates decreased at distances of \u226525.0\u2005km in the Montreal suburbs and midsize cities, at \u226512.5\u2005km in small cities and at \u226550.0\u2005km in rural areas (interaction p&lt;0.0001). The proportion of participants who had their mammography at the nearest DSC decreased with increasing distance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Distance affects participation and this effect varies according to rural\u2013urban classification. The lower participation in Montreal Island, where all women lived &lt;12.5\u2005km from a DSC, argues for a major impact of other characteristics or other dimensions of accessibility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2013-202614","type":"journal-article","created":{"date-parts":[[2013,7,13]],"date-time":"2013-07-13T20:32:18Z","timestamp":1373747538000},"page":"861-867","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Geographic access to mammography screening centre and participation of women in the Quebec Breast Cancer Screening Programme"],"prefix":"10.1136","volume":"67","author":[{"given":"Sylvie","family":"St-Jacques","sequence":"first","affiliation":[{"name":"Direction de l'Analyse et de l\u2019\u00c9valuation des Syst\u00e8mes de Soins et Services, Institut National de Sant\u00e9 Publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathieu D","family":"Philibert","sequence":"additional","affiliation":[{"name":"Vice-pr\u00e9sidence aux affaires scientifiques, Institut National de Sant\u00e9 Publique du Qu\u00e9bec, Montreal, Quebec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Langlois","sequence":"additional","affiliation":[{"name":"Direction de l'Analyse et de l\u2019\u00c9valuation des Syst\u00e8mes de Soins et Services, Institut National de Sant\u00e9 Publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Marc","family":"Daigle","sequence":"additional","affiliation":[{"name":"Direction de l'Analyse et de l\u2019\u00c9valuation des Syst\u00e8mes de Soins et Services, Institut National de Sant\u00e9 Publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9ric","family":"Pelletier","sequence":"additional","affiliation":[{"name":"Direction de l'Analyse et de l\u2019\u00c9valuation des Syst\u00e8mes de Soins et Services, Institut National de Sant\u00e9 Publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Major","sequence":"additional","affiliation":[{"name":"Direction de l'Analyse et de l\u2019\u00c9valuation des Syst\u00e8mes de Soins et Services, Institut National de Sant\u00e9 Publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Brisson","sequence":"additional","affiliation":[{"name":"Direction de l'Analyse et de l\u2019\u00c9valuation des Syst\u00e8mes de Soins et Services, Institut National de Sant\u00e9 Publique du Qu\u00e9bec, Qu\u00e9bec, Qu\u00e9bec, Canada"},{"name":"D\u00e9partement de M\u00e9decine Sociale et Pr\u00e9ventive, Centre de Recherche du CHU de Qu\u00e9bec, Universit\u00e9 Laval, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,7,13]]},"reference":[{"key":"2025100521362269000_67.10.861.1","doi-asserted-by":"crossref","unstructured":"G\u00f8tzsche PC Nielsen M . 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