Socioeconomic Disparity Trends in Cancer Screening Among Women After Introduction of National Quality Indicators

To the authors,

I thoroughly enjoyed reading this article and I thank you for doing such important work. I am a second-year medical student and currently conduct cancer disparity research. I frequently find myself struggling to determine what measure of socioeconomic status (SES) to use in our studies. Your decision to include both individual- and area-level SES in your models was interesting, and was surprised to see that there was no multicollinearity. Do you have any insight as to why there was no multicollinearity between these SES assessments? Out of curiosity, does an Israeli patient have the ability to request a co-pay exemption alongside other social benefits? If so, it would be interesting to ascertain whether there is some degree of stigma that prevents individuals from applying for a co-pay exemption.

I am also curious about the general perceptions of cancer screening and diagnoses in these women. Emerging literature in the United States clearly demonstrates a strong inverse relationship between cervical cancer screening stigma link with HPV and sexually transmitted infections (1). I wonder if perceptions of cervical cancer screening vary substantially from perceptions on breast cancer screening and colorectal cancer screening, and if the perceptions of cancer screening more generally vary by socioeconomic status.

Thank you for publishing this impactful article- it has certainly made me think more deeply about my own work on breast cancer health disparities.

Hayley Dunlop, MPH

References
1. Peterson CE, Silva A, Goben AH, Ongtengco NP, Hu EZ, Khanna D, Nussbaum ER, Jasenof IG, Kim SJ, Dykens JA. Stigma and cervical cancer prevention: A scoping review of the US literature. Preventive Medicine. 2021 Oct 15:106849.