Inequalities in the use of gynecological visits and preventive services for breast and cervical cancer in Roma women in Spain

  • Marisa Usera-Clavero
  • Diana Gil-GonzálezEmail author
  • Daniel La Parra-Casado
  • Carmen Vives-Cases
  • Pilar Carrasco-Garrido
  • Pablo Caballero
Original article



The Roma population in Spain makes up about two percent of the population and has worse health indicators than the general population. We analyzed both populations in 2006 and 2014 to discover whether there are differences in terms of gynecological visits and preventive services for breast and cervical cancer in Spain.


Cross-sectional study is based on the Spanish National Health Survey (SNHS) of 2006 and 2012 and the National Health Survey of the Roma Population (NHSRP) of 2006 and 2014.


Roma women used gynecological visits less than the general population in 2006 (ORa 0.5 [0.4; 0.6] and in 2014 (ORa 0.2 [0.2; 0.3)]. In addition, use of the mammogram was lower in Roma women (ORa 0.7 [0.6; 0.8]), especially in the ages of the screening tests, and they had lower probability of receiving cervical examinations in 2006 (ORa 0.5 [0.4; 0.6]) and in 2014 (ORa 0.7 [0.6; 0.9]).


This study shows that the inequality gap in gynecological visits and preventive services for breast and cervical cancer in Roma women has persisted during the years studied (2006 and 2014), despite Spanish prevention policies.


Roma health Mammography Cervical screening Screening programs Gynecological visits Inequality 



The authors give thanks to the interviewers and associations of the Roma community in Spain for participating in this study.


Ministry of Science, Innovation and Universities of Spain, European Regional Development Funds (ERDF) (“Comparative impact evaluation: Roma National Integration Strategies”, Project Ref. CSO2017-83787-P). Ministry of Economy and Competitiveness of Spain, European Regional Development Funds (ERDF) (“National Health Survey of Roma Population 2013–2014”, Project Ref. PI12/00842). University Research Institute for Gender Studies (IUIEG), for contributing economically in activities leading to doctoral theses that include a gender perspective (2017).

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest.

Ethical approval

The research was approved by the Ethics Committee of the University of Alicante (Spain). Those interviewed were informed in writing and verbally of the objective of the survey, the voluntary nature of participation, the protection of anonymity and confidentiality, and of the institution and team responsible for conducting the survey. No incentive for participation was offered to respondents.


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Copyright information

© Swiss School of Public Health (SSPH+) 2020

Authors and Affiliations

  • Marisa Usera-Clavero
    • 1
  • Diana Gil-González
    • 1
    • 3
    Email author
  • Daniel La Parra-Casado
    • 2
  • Carmen Vives-Cases
    • 1
    • 3
  • Pilar Carrasco-Garrido
    • 4
  • Pablo Caballero
    • 1
  1. 1.Department of Community Nursing, Preventive Medicine and Public Health and History of ScienceUniversity of AlicanteSan Vicente Del Raspeig AlicanteSpain
  2. 2.Department of Sociology IIAlicante UniversityAlicanteSpain
  3. 3.CIBER of Epidemiology and Public Health (CIBER-ESP)BarcelonaSpain
  4. 4.Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences FacultyUniversidad Rey Juan CarlosMadridSpain

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