Association between socioeconomic deprivation and colorectal cancer screening outcomes : Low uptake rates among the most and least deprived people
Buron, Andrea (Hospital del Mar (Barcelona, Catalunya))
Auge, Josep M. (Hospital Clínic i Provincial de Barcelona)
Sala, Maria (Hospital del Mar (Barcelona, Catalunya))
Román, Marta (Hospital del Mar (Barcelona, Catalunya))
Castells, Antoni (Hospital Clínic i Provincial de Barcelona)
Macià, Francesc (Hospital Clínic i Provincial de Barcelona)
Comas Serrano, Mercè (Hospital del Mar (Barcelona, Catalunya))
Guiriguet, Carolina (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Bessa Caserras, Xavier (Universitat Autònoma de Barcelona. Departament de Medicina)
Castells, Xavier (Hospital del Mar (Barcelona, Catalunya))

Date:	2017
Abstract:	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. 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. 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. 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.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	PloS one, Vol. 12 (june 2017) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0179864
PMID: 28622365

13 p, 1001.6 KB

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