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Association between socioeconomic deprivation and colorectal cancer screening outcomes: Low uptake rates among the most and least deprived people

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Listed:
  • Andrea Buron
  • Josep M Auge
  • Maria Sala
  • Marta Román
  • Antoni Castells
  • Francesc Macià
  • Mercè Comas
  • Carolina Guiriguet
  • Xavier Bessa
  • Xavier Castells
  • and the PROCOLON research group

Abstract

Background: Screening with faecal occult blood tests reduces colorectal cancer-related mortality; however, age, sex and socioeconomic factors affect screening outcomes and could lead to unequal mortality benefits. The aim of this study was to describe the main outcomes of the population-based Barcelona colorectal cancer screening programme (BCRCSP) by deprivation. Methods: Retrospective study of the eligible population of the first round of the BCRCSP. Participants’ postal addresses were linked with the MEDEA database to obtain the deprivation quintiles (Dq). Chi-squared tests were used to compare proportions across variables and logistic regression was used to estimate the adjusted effects of age, sex and deprivation on uptake, FIT positivity, colonoscopy adherence and advanced neoplasia detection rate. Results: Overall uptake was 44.7%, higher in Dq2, 3 and 4 (OR 1.251, 1.250 and 1.276, respectively) than in the least deprived quintile (Dq 1), and lowest in Dq5 (OR 0.84). Faecal immunochemical test (FIT) positivity and the percentage of people with detectable faecal haemoglobin below the positivity threshold increased with deprivation. The advanced neoplasia detection rate was highest in Dq4. Conclusion: Unlike most regions where inequalities are graded along the socioeconomic continuum, inequalities in the uptake of colorectal cancer screening in Spain seem to be concentrated first in the most disadvantaged group and second in the least deprived group. The correlation of deprivation with FIT-positivity and faecal haemoglobin below the positivity threshold is worrying due to its association with colorectal cancer and overall mortality.

Suggested Citation

  • Andrea Buron & Josep M Auge & Maria Sala & Marta Román & Antoni Castells & Francesc Macià & Mercè Comas & Carolina Guiriguet & Xavier Bessa & Xavier Castells & and the PROCOLON research group, 2017. "Association between socioeconomic deprivation and colorectal cancer screening outcomes: Low uptake rates among the most and least deprived people," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-13, June.
    • Handle: RePEc:plo:pone00:0179864
    DOI: 10.1371/journal.pone.0179864
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    References listed on IDEAS

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    1. Solmi, Francesca & Von Wagner, Christian & Kobayashi, Lindsay C. & Raine, Rosalind & Wardle, Jane & Morris, Stephen, 2015. "Decomposing socio-economic inequality in colorectal cancer screening uptake in England," Social Science & Medicine, Elsevier, vol. 134(C), pages 76-86.
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    1. Rauf Nouni-García & Ángela Lara-López & Concepción Carratalá-Munuera & Vicente F. Gil-Guillén & Adriana López-Pineda & Domingo Orozco-Beltrán & Jose A. Quesada, 2022. "Factors Associated with Colorectal Cancer Screening in Spain: Results of the 2017 National Health Survey," IJERPH, MDPI, vol. 19(9), pages 1-10, April.

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