Inequalities in colorectal cancer screening participation in the first round of the national screening programme in England

von Wagner, C, Good, A, Wright, D, Rachet, B, Obichere, A, Bloom, S and Wardle, J (2009) Inequalities in colorectal cancer screening participation in the first round of the national screening programme in England. British Journal of Cancer, 101 (S2). S60-S63. ISSN 1532-1827

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Abstract

Background:

Introduction of organised, population-based, colorectal cancer screening in the United Kingdom using the faecal occult blood test (FOBT) has the potential to reduce overall colorectal cancer mortality. However, socio-economic variation in screening participation could exacerbate existing inequalities in mortality.
Methods:

This study examined FOBT uptake rates in London, England in relation to area-level socio-economic deprivation over the first 30 months of the programme during which 401 197 individuals were sent an FOBT kit. Uptake was defined as return of a completed test kit within 3 months. Area-level deprivation in each postcode sector was indexed with the Townsend Material Deprivation Index. Analyses controlled for area-level household mobility, ethnic diversity and poor health, each of which was associated with lower return rates.
Results:

The results showed a strong socio-economic gradient in FOBT uptake, which declined from 49% in the least deprived quintile of postcodes to 38% in the middle quintile and 32% in the most deprived quintile. Variation in socio-economic deprivation between sectors accounted for 62% of the variance in return rates, with little attenuation as a result of controlling for ethnic diversity, household mobility or health status.
Conclusion:

These results highlight the need to understand the causes of socio-economic gradients in screening participation and address barriers that could otherwise increase disparities in colorectal cancer survival.

Item Type: Article
Keywords: colorectal cancer screening, socio-economic status, ethnicity, self-reported health, health inequality
Schools and Departments: School of Psychology > Psychology
Subjects: B Philosophy. Psychology. Religion
Depositing User: Anna Good
Date Deposited: 01 Nov 2012 12:38
Last Modified: 11 Jun 2013 09:14
URI: http://sro.sussex.ac.uk/id/eprint/41806
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