Inequalities in participation in an organized national colorectal cancer screening programme: results from the first 2.6 million invitations in England

Abstract

Overall uptake rates in this organized screening programme were encouraging, but nonetheless there was low uptake in the most ethnically diverse areas and a striking gradient by SES. Action to promote equality of uptake is needed to avoid widening inequalities in cancer mortality.

Decomposing socio-economic inequality in colorectal cancer screening uptake in England

“…A recent study using ELSA data, but including a broader age range, found a 57% uptake of screening (Gale, Deary, Wardle, Zaninotto, & Batty, 2015). Consistent with a previous study (von Wagner, Baio, et al, 2011), we found a strong gradient in uptake with 41.7% of individuals in the poorest and 65.5% in the richest quintiles of predicted nonpension wealth participating in screening. Our findings are also consistent with international studies showing the existence of a gradient in CRC screening regardless of broader system factors (e.g.…”

“…Uptake of screening was higher in our sample (61.0%) than in other studies (von Wagner, Baio, et al, 2011), probably because the age profile meant that the older participants were likely to have been invited over two or more rounds which, as reported recently, can increase uptake (Lo et al, 2014). A recent study using ELSA data, but including a broader age range, found a 57% uptake of screening (Gale, Deary, Wardle, Zaninotto, & Batty, 2015).…”

“…We used such a measure to be consistent with area-level studies which also use composite measures such as the Index of Multiple Deprivation to explore inequalities in uptake of CRC screening(von Wagner, Baio, et al, 2011) and colonoscopy (Morris et al, 2012). We used a generalised linear model (GLM) with gamma family distribution and log link function to regress household net non-pension wealth (divided by 1,000,000) against a number of other socio-economic (education, occupational class, number of vehicles owned, housing tenure, household composition, economic activity) and socio-demographic (gender, age) variables.…”

“…The upper age limit is currently being extended to 75. Overall uptake is approximately 54% (von Wagner, Baio, et al, 2011), although rates are higher when several screening rounds are included (Lo et al, 2014). There is evidence of substantial variation in uptake by socio-economic status, with one study finding participation in the most deprived quintile of residential areas to be only 35%, compared with 61% in the least deprived quintile (von Wagner, Baio, et al, 2011).…”

“…Overall uptake is approximately 54% (von Wagner, Baio, et al, 2011), although rates are higher when several screening rounds are included (Lo et al, 2014). There is evidence of substantial variation in uptake by socio-economic status, with one study finding participation in the most deprived quintile of residential areas to be only 35%, compared with 61% in the least deprived quintile (von Wagner, Baio, et al, 2011). Previous studies have also shown systematic differences in CRC screening participation between geographical regions of England, with London and the North East reporting the lowest and highest rates of screening, respectively (Logan et al, 2012;von Wagner, Baio, et al, 2011).…”