The current study examines whether the extent of macrolevel gender inequality affects the association between women’s educational attainment and their participation in cervical and breast cancer screening and how this relationship is moderated by a country’s cancer screening strategy (organized vs. opportunistic). A multilevel design with women (N_cervical = 99,794; N_breast = 55,021) nested in 30 European countries was used to analyze data from the European Health Interview Survey (2013–2015). Results of multilevel logistic regression models demonstrate that higher macrolevel gender inequality is associated with (a) a lower overall likelihood that women have had a mammography and Pap smear and (b) a larger gap in participation between women with low and high levels of education, regardless of a country’s screening strategy (i.e., no moderation by a country’s screening strategy was found). We conclude that macrolevel gender stratification should not be neglected when designing cancer screening policy.

目前的研究调查了宏观层面性别不平等的程度是否会影响女性受教育程度与其参与宫颈癌和乳腺癌筛查之间的关联，以及国家的癌症筛查策略（有组织的还是机会主义的）如何调节这种关系。女性多层次设计（N_宫颈= 99,794；N_乳房= 55,021) 嵌套在 30 个欧洲国家，用于分析欧洲健康访谈调查 (2013-2015) 的数据。多级逻辑回归模型的结果表明，较高的宏观性别不平等与 (a) 女性接受乳房 X 光检查和子宫颈抹片检查的总体可能性较低以及 (b) 受教育程度低和受教育程度高的女性之间的参与差距更大有关，无论一个国家的筛查策略如何（即没有发现国家的筛查策略有调节作用）。我们得出的结论是，在设计癌症筛查政策时不应忽视宏观层面的性别分层。