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Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing
BACKGROUND: CRC mortality rates are higher for individuals with a lower socioeconomic status (SES). Screening could influence health inequalities. We therefore aimed to investigate SES differences in participation and diagnostic yield of FIT screening. METHODS: All invitees in 2014 and 2015 in the D...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853540/ https://www.ncbi.nlm.nih.gov/pubmed/35176116 http://dx.doi.org/10.1371/journal.pone.0264067 |
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author | van der Meulen, Miriam P. Toes-Zoutendijk, Esther Spaander, Manon C. W. Dekker, Evelien Bonfrer, Johannes M. G. van Vuuren, Anneke J. Kuipers, Ernst J. van Kemenade, Folkert J. van Velthuysen, M. F. Thomeer, Maarten G. J. van Veldhuizen, Harriët de Koning, Harry J. Lansdorp-Vogelaar, Iris van Leerdam, Monique E. |
author_facet | van der Meulen, Miriam P. Toes-Zoutendijk, Esther Spaander, Manon C. W. Dekker, Evelien Bonfrer, Johannes M. G. van Vuuren, Anneke J. Kuipers, Ernst J. van Kemenade, Folkert J. van Velthuysen, M. F. Thomeer, Maarten G. J. van Veldhuizen, Harriët de Koning, Harry J. Lansdorp-Vogelaar, Iris van Leerdam, Monique E. |
author_sort | van der Meulen, Miriam P. |
collection | PubMed |
description | BACKGROUND: CRC mortality rates are higher for individuals with a lower socioeconomic status (SES). Screening could influence health inequalities. We therefore aimed to investigate SES differences in participation and diagnostic yield of FIT screening. METHODS: All invitees in 2014 and 2015 in the Dutch national CRC screening programme were included in the analyses. We used area SES as a measure for SES and divided invitees into quintiles, with Quintile 1 being the highest SES. Logistic regression analysis was used to compare the participation rate, positivity rate, colonoscopy uptake, positive predictive value (PPV) and detection rate across the SES groups. RESULTS: Participation to FIT screening was significantly lower for Quintile 5 (67.0%) compared to the other Quintiles (73.0% to 75.1%; adjusted OR quintile 5 versus quintile 1: 0.73, 95%CI: 0.72–0.74), as well as colonoscopy uptake after a positive FIT (adjusted OR 0.73, 95%CI: 0.69–0.77). The detection rate per FIT participant for advanced neoplasia gradually increased from 3.3% in Quintile 1 to 4.0% in Quintile 5 (adjusted OR 1.20%, 95%CI 1.16–1.24). As a result of lower participation, the yield per invitee was similar for Quintile 5 (2.04%) and Quintile 1 (2.00%), both being lower than Quintiles 2 to 4 (2.20%-2.28%). CONCLUSIONS: Screening has the potential to reduce health inequalities in CRC mortality, because of a higher detection in participants with a lower SES. However, in the Dutch screening programme, this is currently offset by the lower participation in this group. |
format | Online Article Text |
id | pubmed-8853540 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-88535402022-02-18 Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing van der Meulen, Miriam P. Toes-Zoutendijk, Esther Spaander, Manon C. W. Dekker, Evelien Bonfrer, Johannes M. G. van Vuuren, Anneke J. Kuipers, Ernst J. van Kemenade, Folkert J. van Velthuysen, M. F. Thomeer, Maarten G. J. van Veldhuizen, Harriët de Koning, Harry J. Lansdorp-Vogelaar, Iris van Leerdam, Monique E. PLoS One Research Article BACKGROUND: CRC mortality rates are higher for individuals with a lower socioeconomic status (SES). Screening could influence health inequalities. We therefore aimed to investigate SES differences in participation and diagnostic yield of FIT screening. METHODS: All invitees in 2014 and 2015 in the Dutch national CRC screening programme were included in the analyses. We used area SES as a measure for SES and divided invitees into quintiles, with Quintile 1 being the highest SES. Logistic regression analysis was used to compare the participation rate, positivity rate, colonoscopy uptake, positive predictive value (PPV) and detection rate across the SES groups. RESULTS: Participation to FIT screening was significantly lower for Quintile 5 (67.0%) compared to the other Quintiles (73.0% to 75.1%; adjusted OR quintile 5 versus quintile 1: 0.73, 95%CI: 0.72–0.74), as well as colonoscopy uptake after a positive FIT (adjusted OR 0.73, 95%CI: 0.69–0.77). The detection rate per FIT participant for advanced neoplasia gradually increased from 3.3% in Quintile 1 to 4.0% in Quintile 5 (adjusted OR 1.20%, 95%CI 1.16–1.24). As a result of lower participation, the yield per invitee was similar for Quintile 5 (2.04%) and Quintile 1 (2.00%), both being lower than Quintiles 2 to 4 (2.20%-2.28%). CONCLUSIONS: Screening has the potential to reduce health inequalities in CRC mortality, because of a higher detection in participants with a lower SES. However, in the Dutch screening programme, this is currently offset by the lower participation in this group. Public Library of Science 2022-02-17 /pmc/articles/PMC8853540/ /pubmed/35176116 http://dx.doi.org/10.1371/journal.pone.0264067 Text en © 2022 van der Meulen et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article van der Meulen, Miriam P. Toes-Zoutendijk, Esther Spaander, Manon C. W. Dekker, Evelien Bonfrer, Johannes M. G. van Vuuren, Anneke J. Kuipers, Ernst J. van Kemenade, Folkert J. van Velthuysen, M. F. Thomeer, Maarten G. J. van Veldhuizen, Harriët de Koning, Harry J. Lansdorp-Vogelaar, Iris van Leerdam, Monique E. Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing |
title | Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing |
title_full | Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing |
title_fullStr | Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing |
title_full_unstemmed | Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing |
title_short | Socioeconomic differences in participation and diagnostic yield within the Dutch national colorectal cancer screening programme with faecal immunochemical testing |
title_sort | socioeconomic differences in participation and diagnostic yield within the dutch national colorectal cancer screening programme with faecal immunochemical testing |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853540/ https://www.ncbi.nlm.nih.gov/pubmed/35176116 http://dx.doi.org/10.1371/journal.pone.0264067 |
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