학술논문
Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing.
Document Type
Article
Author
van der Meulen, Miriam P.; Toes-Zoutendijk, Esther; Spaander, Manon C. W.; Dekker, Evelien; Bonfrer, Johannes M. G.; van Vuuren, Anneke J.; Kuipers, Ernst J.; van Kemenade, Folkert J.; van Velthuysen, M. F.; Thomeer, Maarten G. J.; van Veldhuizen, Harriët; de Koning, Harry J.; Lansdorp-Vogelaar, Iris; van Leerdam, Monique E.
Source
Subject
*EARLY detection of cancer
*COLORECTAL cancer
*MEDICAL screening
*HEALTH equity
*LOGISTIC regression analysis
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Language
ISSN
1932-6203
Abstract
Background: CRC mortality rates are higher for individuals with a lower socioeconomic status (SES). Screening could influence health inequalities. We therefore aimed to investigate SES differences in participation and diagnostic yield of FIT screening. Methods: All invitees in 2014 and 2015 in the Dutch national CRC screening programme were included in the analyses. We used area SES as a measure for SES and divided invitees into quintiles, with Quintile 1 being the highest SES. Logistic regression analysis was used to compare the participation rate, positivity rate, colonoscopy uptake, positive predictive value (PPV) and detection rate across the SES groups. Results: Participation to FIT screening was significantly lower for Quintile 5 (67.0%) compared to the other Quintiles (73.0% to 75.1%; adjusted OR quintile 5 versus quintile 1: 0.73, 95%CI: 0.72–0.74), as well as colonoscopy uptake after a positive FIT (adjusted OR 0.73, 95%CI: 0.69–0.77). The detection rate per FIT participant for advanced neoplasia gradually increased from 3.3% in Quintile 1 to 4.0% in Quintile 5 (adjusted OR 1.20%, 95%CI 1.16–1.24). As a result of lower participation, the yield per invitee was similar for Quintile 5 (2.04%) and Quintile 1 (2.00%), both being lower than Quintiles 2 to 4 (2.20%-2.28%). Conclusions: Screening has the potential to reduce health inequalities in CRC mortality, because of a higher detection in participants with a lower SES. However, in the Dutch screening programme, this is currently offset by the lower participation in this group. [ABSTRACT FROM AUTHOR]