TY - JOUR
T1 - Sociodemographic characteristics of nonparticipants in the Danish colorectal cancer screening program
T2 - a nationwide cross-sectional study
AU - Larsen, M. B.
AU - Mikkelsen, E. M.
AU - Rasmussen, M.
AU - Friis-Hansen, L.
AU - Ovesen, Anders Uth
AU - Rahr, Hans B
AU - Andersen, B.
N1 - ISI Document Delivery No.: EY7OP Times Cited: 0 Cited Reference Count: 46 Larsen, Mette Bach Mikkelsen, Ellen M. Rasmussen, Morten Friis-Hansen, Lennart Ovesen, Anders U. Rahr, Hans Bjarke Andersen, Berit 0 Dove medical press ltd Albany
PY - 2017
Y1 - 2017
N2 - Introduction: Fecal occult blood tests are recommended for colorectal cancer (CRC) screening in Europe. Recently, the fecal immunochemical test (FIT) has come into use. Sociodemographic differences between participants and nonparticipants may be less pronounced when using FIT as there are no preceding dietary restrictions and only one specimen is required. The aim of this study was to examine the associations between sociodemographic characteristics and nonparticipation for both genders, with special emphasis on those who actively unsubscribe from the program. Methods: The study was a national, register-based, cross-sectional study among men and women randomized to be invited to participate in the prevalence round of the Danish CRC screening program between March 1 and December 31, 2014. Prevalence ratios (PRs) were used to quantify the association between sociodemographic characteristics and nonparticipation (including active nonparticipation). PRs were assessed using Poisson regression with robust error variance. Results: The likelihood of being a nonparticipant was highest in the younger part of the population; however, for women, the association across age groups was U-shaped. Female immigrants were more likely to be nonparticipants. Living alone, being on social welfare, and having lower income were factors that were associated with nonparticipation among both men and women. For both men and women, there was a U-shaped association between education and nonparticipation. For both men and women, the likelihood of active nonparticipation rose with age; it was lowest among non-western immigrants and highest among social welfare recipients. Conclusion: Social inequality in screening uptake was evident among both men and women in the Danish CRC screening program, even though the program is free of charge and the screening kit is based on FIT and mailed directly to the individuals. Interventions are needed to bridge this gap if CRC screening is to avoid aggravating existing inequalities in CRC-related morbidity and mortality.
AB - Introduction: Fecal occult blood tests are recommended for colorectal cancer (CRC) screening in Europe. Recently, the fecal immunochemical test (FIT) has come into use. Sociodemographic differences between participants and nonparticipants may be less pronounced when using FIT as there are no preceding dietary restrictions and only one specimen is required. The aim of this study was to examine the associations between sociodemographic characteristics and nonparticipation for both genders, with special emphasis on those who actively unsubscribe from the program. Methods: The study was a national, register-based, cross-sectional study among men and women randomized to be invited to participate in the prevalence round of the Danish CRC screening program between March 1 and December 31, 2014. Prevalence ratios (PRs) were used to quantify the association between sociodemographic characteristics and nonparticipation (including active nonparticipation). PRs were assessed using Poisson regression with robust error variance. Results: The likelihood of being a nonparticipant was highest in the younger part of the population; however, for women, the association across age groups was U-shaped. Female immigrants were more likely to be nonparticipants. Living alone, being on social welfare, and having lower income were factors that were associated with nonparticipation among both men and women. For both men and women, there was a U-shaped association between education and nonparticipation. For both men and women, the likelihood of active nonparticipation rose with age; it was lowest among non-western immigrants and highest among social welfare recipients. Conclusion: Social inequality in screening uptake was evident among both men and women in the Danish CRC screening program, even though the program is free of charge and the screening kit is based on FIT and mailed directly to the individuals. Interventions are needed to bridge this gap if CRC screening is to avoid aggravating existing inequalities in CRC-related morbidity and mortality.
KW - colorectal neoplasms mass screening early detection of cancer socioeconomic factors demography occult blood-tests fecal immunochemical tests controlled-trials participation metaanalysis colon colonoscopy survival registry england Public, Environmental & O
U2 - 10.2147/clep.s139168
DO - 10.2147/clep.s139168
M3 - Journal article
SN - 1179-1349
VL - 9
SP - 345
EP - 354
JO - Clinical Epidemiology
JF - Clinical Epidemiology
ER -