The role of area-level deprivation and gender in participation in population-based faecal immunochemical test (FIT) colorectal cancer screening

Nicholas Clarke, Deirdre McNamara, Patricia M. Kearney, Colm A. O'Morain, Nikki Shearer, Linda Sharp

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

This study aimed to investigate the effects of sex and deprivation on participation in a population-based faecal immunochemical test (FIT) colorectal cancer screening programme. The study population included 9785 individuals invited to participate in two rounds of a population-based biennial FIT-based screening programme, in a relatively deprived area of Dublin, Ireland. Explanatory variables included in the analysis were sex, deprivation category of area of residence and age (at end of screening). The primary outcome variable modelled was participation status in both rounds combined (with “participation” defined as having taken part in either or both rounds of screening). Poisson regression with a log link and robust error variance was used to estimate relative risks (RR) for participation. As a sensitivity analysis, data were stratified by screening round. In both the univariable and multivariable models deprivation was strongly associated with participation. Increasing affluence was associated with higher participation; participation was 26% higher in people resident in the most affluent compared to the most deprived areas (multivariable RR = 1.26: 95% CI 1.21–1.30). Participation was significantly lower in males (multivariable RR = 0.96: 95%CI 0.95–0.97) and generally increased with increasing age (trend per age group, multivariable RR = 1.02: 95%CI, 1.01–1.02). No significant interactions between the explanatory variables were found. The effects of deprivation and sex were similar by screening round. Deprivation and male gender are independently associated with lower uptake of population-based FIT colorectal cancer screening, even in a relatively deprived setting. Development of evidence-based interventions to increase uptake in these disadvantaged groups is urgently required.

Original languageEnglish
Pages (from-to)198-203
Number of pages6
JournalPreventive Medicine
Volume93
DOIs
Publication statusPublished - 01 Dec 2016
Externally publishedYes

Keywords

  • Cancer
  • Colorectal
  • Deprivation
  • Faecal Immunochemical Test
  • FIT
  • Gender
  • Participation
  • Screening

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