Differences in colorectal cancer screening rates across income strata by levels of urbanization: results from the Canadian Community Health Survey (2013/2014)

Abstract

Objective Canadian colorectal cancer screening rates differ across income strata. In the United States, disparities across income strata worsen in rural areas. In Canada, differences in screening across income strata have not been explored by levels of urbanization. This project aimed to estimate up-to-date colorectal cancer (UTD-CRC) screening across income strata by levels of urbanization. Methods Data from the Canadian Community Health Survey (2013/2014) were used to estimate the prevalence of UTD-CRC screening by income quintiles for Canadians aged 50-74 years. UTD-CRC screening was defined as fecal occult blood testing within 2 years or colonoscopy/sigmoidoscopy within 10 years before the survey. Levels of urbanization were defined per Statistics Canada Metropolitan Influenced Zone classifications. Weighted proportions of UTD-CRC screening were calculated and logistic regression was used to assess the effect of income by levels of urbanization. Results Self-reported UTD-CRC screening prevalence among Canadians was 52.0%. UTD-CRC screening rates by income ranged from 47.8% (Q1-low) to 54.0% (Q5-high). Across all levels of urbanization, higher income was associated with increased odds of UTD-CRC screening compared to the lowest income quintile (

Projected estimates of cancer in Canada in 2022

“…In most provinces and territories, screening rates are far below the recommended levels, often with considerably lower rates among historically underscreened populations (visible minorities, immigrants, people in lower socioeconomic groups, and First Nations, Inuit and Métis people). 20,21 Recently, several provinces have launched organized lung-cancer screening programs for individuals at high risk of getting lung cancer, 22,23 while others have implemented business cases, pilots and studies. 24 Although mortality and survival have improved considerably over the past 3 decades for many cancer types, for others, additional research and investment into novel screening approaches and therapies are needed.…”

Projection du fardeau du cancer au Canada en 2022

“…Il faut déployer plus d’efforts pour maximiser l’adoption et l’adhésion de tous les segments de la population canadienne par le biais de pratiques adaptées sur le plan culturel. Dans la plupart des provinces et des territoires, les taux de dépistage sont bien en deçà des niveaux recommandés, et souvent les taux sont considérablement plus faibles parmi les populations historiquement sous-dépistées (minorités visibles, immigrants, personnes appartenant aux groupes socioéconomiques inférieurs, et Premières Nations, Inuits et Métis) 20 , 21 . Récemment, plusieurs provinces ont lancé des programmes organisés de dépistage du cancer du poumon pour les personnes à haut risque de développer un cancer du poumon 22 , 23 , tandis que d’autres ont mis en œuvre des analyses de rentabilité, des projets pilotes et des études 24 .…”

Canadian Colorectal Cancer Screening Guidelines: Do They Need an Update Given Changing Incidence and Global Practice Patterns?

“…Some provincial programs had been implemented more recently than others at data collection, likely contributing to this variation. Younger age, lower income and education level, living in a rural area, smoking and self-identifying as an immigrant are further predictors for decreased screening participation [34,35]. A study using the Manitoba Cancer Registry showed increased CRC mortality among residents of lowerincome areas, highlighting a need to focus on screening access and promotion in lowerincome populations [34,36].…”