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

Lookup NU author(s): Professor Linda Sharp


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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. (C) 2016 Published by Elsevier Inc.

Publication metadata

Author(s): Clarke N, McNamara D, Kearney P, O'Morain C, Shearer N, Sharp L

Publication type: Article

Publication status: Published

Journal: Preventive Medicine

Year: 2016

Volume: 93

Pages: 198-203

Print publication date: 01/12/2016

Online publication date: 18/10/2016

Acceptance date: 13/10/2016

ISSN (print): 0091-7435

ISSN (electronic): 1096-0260

Publisher: Elsevier


DOI: 10.1016/j.ypmed.2016.10.012


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Funder referenceFunder name
CRS11CLAIrish Cancer Society