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Colorectal cancer screening programs can reduce colorectal cancer mortality.
However, the implementation of a screening program may create or exacerbate socioeconomic and ethnic health inequities if participation varies by subgroup.
Professor Evelien Dekker and colleagues of The Netherlands determined which organized programs characterize participation inequities by socioeconomic and ethnic subgroups, and assessed the variation in subgroup participation among programmes collecting group-specific data.
Employing a literature review and survey among leaders of national or regional screening programs, this study identified published and unpublished data on participation by socioeconomic status and ethnicity.
The team assessed programs offering faecal occult blood tests for screening. Primary outcome was screening participation rate.
Across 24 organized fecal occult blood tests-screening programs meeting the inclusion criteria, participation rates ranged from 21% to 73%.
Most programs did not collect data on participation by socioeconomic status and ethnicity.
Among the 11 programs with data on participation by socioeconomic status, 90% reported lower participation among lower socioeconomic groups.
Differences across socioeconomic gradients were moderate to severe.
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| Among the 11 programs
, 90% reported lower participation among lower socioeconomic
groups |
| Gut |
Only 6 programs reported participation results by ethnicity.
Ethnic differences were moderate, though only limited data were available for evaluation.
Professor Dekker's team concluded, "Cross organized colorectal cancer screening programs worldwide, variation in participation by socioeconomic status and ethnicity is often not assessed."
"However, when measured, marked disparities in participation by socioeconomic status have been observed."
"Limited data were available to assess inequities by ethnicity."
"To avoid exacerbating health inequities, screening programs should systematically monitor participation by socioeconomic status and ethnicity, and investigate and address determinants of low participation."
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