Isabel Mosquera1,2,3, Nere Mendizabal4, Unai Martín2,3, Amaia Bacigalupe2,3, Elena Aldasoro5, Isabel Portillo1,6. 1. Cirugía Computacional, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain. 2. Department of Sociology 2, Social and Communication Sciences Faculty, University of the Basque Country UPV-EHU, Leioa, Bizkaia, Spain. 3. OPIK - Research Group on Social Determinants of Health and Demographic Change, Leioa, Bizkaia, Spain. 4. Integración de la Prevención y Promoción de la Salud en la Práctica Clínica, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain. 5. Ministry of Health of the Basque Government, Office of Public Health and Addictions, Vitoria-Gasteiz, Araba, Spain. 6. Osakidetza Basque Health Service, Colorectal Cancer Screening Programme, Bilbao, Bizkaia, Spain.
Abstract
BACKGROUND: Colorectal cancer (CRC) is a major public health problem due to its incidence and mortality. Screening programmes help decrease its impact on the population through early detection. However, the uneven distribution of social determinants of health can cause inequalities. The aim of this study is to identify the social inequalities in the participation in CRC screening programmes. METHODS: A systematic review of the literature was carried out, searching in both health and social databases for papers published since 2000 in English, Spanish, Portuguese and French. The search strategies combined terms regarding screening, CRC, participation and social inequalities. Included papers were quantitative or qualitative primary studies analyzing gender and socioeconomic inequalities in the participation in CRC screening programmes implemented by public and private health-care providers and addressing 45- to 75-year-old population. RESULTS: A total of 96 studies, described in 102 articles, were included. Most were quantitative observational studies and analyzed population-based screening programmes. They were carried out mainly in the UK (n=29) and the USA (n=18). Participation in screening programmes varied from 1.1% to 82.8% using several methods. A total of 87 studies assessed participation by sex and one focussed on men, but only two provided an analysis from a gender perspective. Although men are at a higher risk of developing CRC, they generally were less likely to participate in screening programmes. Screening attendance was higher among the least deprived areas. CONCLUSIONS: Gender and socioeconomic inequalities in CRC screening participation should be addressed through the design of tailored interventions with a multidimensional focus.
BACKGROUND:Colorectal cancer (CRC) is a major public health problem due to its incidence and mortality. Screening programmes help decrease its impact on the population through early detection. However, the uneven distribution of social determinants of health can cause inequalities. The aim of this study is to identify the social inequalities in the participation in CRC screening programmes. METHODS: A systematic review of the literature was carried out, searching in both health and social databases for papers published since 2000 in English, Spanish, Portuguese and French. The search strategies combined terms regarding screening, CRC, participation and social inequalities. Included papers were quantitative or qualitative primary studies analyzing gender and socioeconomic inequalities in the participation in CRC screening programmes implemented by public and private health-care providers and addressing 45- to 75-year-old population. RESULTS: A total of 96 studies, described in 102 articles, were included. Most were quantitative observational studies and analyzed population-based screening programmes. They were carried out mainly in the UK (n=29) and the USA (n=18). Participation in screening programmes varied from 1.1% to 82.8% using several methods. A total of 87 studies assessed participation by sex and one focussed on men, but only two provided an analysis from a gender perspective. Although men are at a higher risk of developing CRC, they generally were less likely to participate in screening programmes. Screening attendance was higher among the least deprived areas. CONCLUSIONS: Gender and socioeconomic inequalities in CRC screening participation should be addressed through the design of tailored interventions with a multidimensional focus.
Authors: M Solís-Ibinagagoitia; S Unanue-Arza; M Díaz-Seoane; L Martínez-Indart; A Lebeña-Maluf; I Idigoras; I Bilbao; I Portillo Journal: Front Public Health Date: 2020-12-11
Authors: U Strömberg; C Bonander; M Westerberg; L Å Levin; C Metcalfe; R Steele; L Holmberg; A Forsberg; R Hultcrantz Journal: EClinicalMedicine Date: 2022-04-16