In many parts of Western Europe the age at first marriage and the level of celibacy declined in the second half of the 19th century. This weakening of the European marriage pattern (EMP) can be interpreted as a “classic” response to the increase of the standard of living, but a more far‐reaching interpretation is that the erosion of the EMP was part of a cultural shift characterized by the rise of a new, less instrumental and more egalitarian view on marriage and partner selection. The latter vision implies the increase of the preference for a same age marriage. We test this explanation by using a combined Belgian‐Dutch data set of marriage certificates (N = 766,412). Our findings corroborate the “cultural shift thesis.”

Background Many breast, colorectal, and cervical cancer screening programs were disrupted due to the COVID-19 pandemic. This study aimed to estimate the short-term impact of the temporary shutdown (from March until May- June) of the cancer screening programs invitations in Flanders (Belgium) by looking at invitation coverage, percentage of people screened after invitation and the screening interval. Methods Yearly invitation coverage was calculated as the number of people who received an invitation, as a proportion of the people who should have received an invitation that year. Weekly response to the invitation was calculated as the number of people who were screened within 40 days of their date of invitation, as a percentage of the people who received an invitation that week (as a proxy for willingness to screen). Weekly screening interval was calculated as the mean number of months between the current screening and the previous screening of all the people who screened that week. The two last indicators were calculated for each week in 2019 and 2020, after which the difference between that week’s value in 2020 and 2019 with 95% confidence intervals. Results of these two indicators were also analysed after stratification for gender, age and participation history. Results Invitation coverage was not impacted in the colorectal and cervical cancer screening program. In the breast cancer screening program invitation coverage went down from 97.5% (2019) to 88.7% (2020), and the backlog of invitations was largely resolved in the first six months of 2021. The willingness to screen was minimally influenced by COVID-19. The breast cancer screening program had a temporary increase in screening interval in the first months following the restart after COVID-19 related shutdown, when it was on average 2.1 months longer than in 2019. Conclusions Willingness to screen was minimally influenced by COVID-19, but there may be an influence on screening coverage because of lower invitation coverage, mainly for the for breast Cancer Screening Program. The increases in screening intervals for the three Cancer Screening Program seem reasonable and would probably not significantly increase the risk of delayed screening cancer diagnoses. When restarting a Cancer Screening Program after a COVID-19 related shutdown, monitoring is crucial.

Dyadic latent panel analysis (DLPA) was applied to eight waves of the Panel Study of Belgium Households (N = 954 couples). DLPA decomposes the observed variance of both members of a dyad into variance due to stable factors, factors that gradually change over time, and occasion-specific factors including random error. Total observed similarity between members of a dyad on one occasion is decomposed into stable similarity, similarity in factors that change over time, and occasion-specific similarity. The results show that depressive symptoms are influenced by stable and changing factors and that spousal similarity in both factors contribute to spousal similarity in depression on a single occasion. Spousal similarity in factors that change gradually over time suggests that shared-environmental factors contribute to depressive symptoms.

We investigated factors associated with organised and non-organised colorectal cancer screening using faecal occult blood tests, based on data from 308 municipalities in Flanders (6.6 million residents, 57% of Belgium) during 2015–2017. Logistic regression with generalized estimating equations was used to assess the associations between municipal characteristics and organised and non-organised screening coverages. Factors associated negatively with both organised and non-organised screening: percentage of people aged 70–74 in the target population [OR (odds ratios) = 0.98, 95%CI (confidence interval): 0.97–0.99 and OR = 0.98, 95%CI: 0.96–0.999, respectively]; negatively with organised screening: average income [OR = 0.97, 95%CI: 0.96–0.98], percentage of people with a non-Belgian/Dutch nationality [OR = 0.962, 95%CI: 0.957–0.967]; positively with organised screening: percentages of men in the target population [OR = 1.13, 95%CI: 1.11–1.14], jobseekers [OR = 1.12, 95%CI: 1.09–1.15] and people with at least one general practitioner (GP) visit in the last year [OR = 1.04, 95%CI: 1.03–1.05]; positively with non-organised screening: number of patients per GP [OR = 1.021, 95%CI: 1.016–1.026], percentage of people with a global medical dossier handled by a preferred GP [OR = 1.025, 95%CI: 1.018–1.031]. This study helps to identify the hard-to-reach subpopulations in CRC screening, and highlights the important role of GPs in the process of promoting screening among non-participants and encouraging non-organised participants to switch to organised screening.

Background Breast cancer (BC) is the most common cancer in women in the developed world. In order to find developing cancers in an early stage, BC screening is commonly used. In Flanders, screening is performed in and outside an organized breast cancer screening program (BCSP). However, the determinants of BC screening coverage for both screening strategies are yet unknown. Objective To assess the determinants of BC screening coverage in Flanders. Methods Reimbursement data were used to attribute a screening status to each woman in the target population for the years 2008–2016. Yearly coverage data were categorized as screening inside or outside BCSP or no screening. Data were clustered by municipality level. A generalized linear equation model was used to assess the determinants of screening type. Results Over all years and municipalities, the median screening coverage rate inside and outside BCSP was 48.40% (IQR: 41.50–54.40%) and 14.10% (IQR: 9.80–19.80%) respectively. A higher coverage rate outside BSCP was statistically significantly (P < 0.001) associated with more crowded households (OR: 3.797, 95% CI: 3.199–4.508), younger age, higher population densities (OR: 2.528, 95% CI: 2.455–2.606), a lower proportion of unemployed job seekers (OR: 0.641, 95% CI: 0.624–0.658) and lower use of dental care (OR: 0.969, 95% CI: 0.967–0.972). Conclusion Coverage rate of BC screening is not optimal in Flanders. Women with low SES that are characterized by younger age, living in a high population density area, living in crowded households, or having low dental care are less likely to be screened for BC in Flanders. If screened, they are more likely to be screened outside the BCSP.