Intergenerational transmission of preventive health-seeking behaviors: Like mother, like daughter? The case of cancer screening in France

One of the driving forces behind the persistence of social health inequalities is the intergenerational transmission of health, which occurs through both hereditary and environmental factors. Within this second pathway, the literature has primarily focused on the transmission of lifestyle-related health behaviors. This study expands on these mechanisms by focusing on the intergenerational transmission of preventive health-seeking behaviors, specifically cervical and breast cancer screening. We used data from the French E3N-Generations cohorts, which, despite being highly selected, uniquely track several generations of women over a long period. Our analysis draws on surveys conducted at the mothers' level between 1990 and 2014, and on a survey at the daughters' level launched in 2018. We employed conditional mixed process models to estimate the association between mothers' mammogram use (n = 6386) and their daughters' likelihood of regularly undergoing mammograms and Pap smears (n = 7012), while controlling for additional explanatory channels such as risk, socioeconomic status, and territorial context. Daughters whose mothers reported mammogram use across all survey waves, compared to none, were 8.4pp [4; 12pp] more likely to have a Pap smear at least every three years, and 17pp [12; 22pp] more likely to have a mammogram every two years, suggesting a transmission of preventive health-seeking behaviors. Thus, interventions aimed at increasing screening rates among women with lower engagement in preventive care could benefit both current and future generations, helping to break the cycle of social health inequalities.