354 Social inequality in Mexico in the use of prostate-specific antigen screening for the detection of prostate cancer: an analysis of the 2018, 2021, 2022, and 2023 national health surveys

Abstract PTH 7: Health Policy and Health Services 2, B308 (FCSH), September 5, 2025, 11:30 - 12:24 Aim To measure health inequality in Mexico using of Prostate Specific Antigen (PSA) as prostate cancer screening in male aged 45-70 years, based on the 2018, 2021, 2022 and 2023 national health surveys. Methods Considering the selection of 5 social stratifies to evaluate the prostate cancer screening coverage based on PSA measurement in the last year (schooling, ethnicity, unemployment, socioeconomic level and type of health protection); the Kuznets index, the slope inequality index and the health concentration index were estimated. Results Although global test coverage increased by 4 percentage points from 2018 to 2023, it remains limited (13.6% [CI: 12.5-14.9] to 17.6% [14.5-21.2] respectively). The observed inequity remains greater in men with less education and without social security: 10.6 years of average education versus 8.7; 18.9% in men who had social security versus 8.9% without health protection in 2018 versus 23.8% in men who had social security versus 11.1% without health protection in 2023. While for the first time in the last 6 years, coverage in 2023 was higher in indigenous compared to non-indigenous people (in 2018, a detection rate of 7.4% was reported in indigenous men versus 14.1% in non-indigenous men, versus 19.0% in indigenous men and 17.5% in non-indigenous men according to the 2023 national survey). Conclusion The social stratifier that showed the greatest inequality gap was having or not having social security, maintaining a ratio of 2 times more in favor of those who have social security. While it is important to monitor the performance of curative services, the challenge of ensuring effective and equitable access to early diagnosis services remains, particularly when prostate cancer is the leading cause of death from oncological diseases in men in Mexico. Keywords health status disparities; social inequity, prostate cancer, secondary prevention; Mexico