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Colorectal Cancer Screening in Switzerland: Cross-Sectional Trends (2007-2012) in Socioeconomic Disparities.

Fedewa SA, Cullati S, Bouchardy C, Welle I, Burton-Jeangros C, Manor O, Courvoisier DS, Guessous I - PLoS ONE (2015)

Bottom Line: CRC screening prevalence was greater in the highest income (>$6,000) vs. lowest income (≤$2,000) group in 2007 (24.5% vs. 10.5%, PR:1.37, 95%CI: 0.96-1.96) and in 2012 (28.6% vs. 16.0%, PR:1.45, 95%CI: 1.09-1.92); this disparity did not significantly change over time.While CRC screening prevalence in Switzerland increased from 2007 to 2012, CRC screening coverage remains low and disparities in CRC screening by income persisted over time.These findings highlight the need for increased access to CRC screening as well as enhanced awareness of the benefits of CRC screening in the Swiss population, particularly among low-income residents.

View Article: PubMed Central - PubMed

Affiliation: Emory University, Department of Epidemiology, Atlanta, GA, United States of America; American Cancer Society, Atlanta, GA, United States of America.

ABSTRACT

Background: Despite universal health care coverage, disparities in colorectal cancer (CRC) screening by income in Switzerland have been reported. However, it is not known if these disparities have changed over time. This study examines the association between socioeconomic position and CRC screening in Switzerland between 2007 and 2012.

Methods: Data from the 2007 (n = 5,946) and 2012 (n = 7,224) population-based Swiss Health Interview Survey data (SHIS) were used to evaluate the association between monthly household income, education, and employment with CRC screening, defined as endoscopy in the past 10 years or fecal occult blood test (FOBT) in the past 2 years. Multivariable Poisson regression was used to estimate prevalence ratios (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status, and health utilization.

Results: CRC screening increased from 18.9% in 2007 to 22.2% in 2012 (padjusted: = 0.036). During the corresponding time period, endoscopy increased (8.2% vs. 15.0%, padjusted:<0.001) and FOBT decreased (13.0% vs. 9.8%, padjusted:0.002). CRC screening prevalence was greater in the highest income (>$6,000) vs. lowest income (≤$2,000) group in 2007 (24.5% vs. 10.5%, PR:1.37, 95%CI: 0.96-1.96) and in 2012 (28.6% vs. 16.0%, PR:1.45, 95%CI: 1.09-1.92); this disparity did not significantly change over time.

Conclusions: While CRC screening prevalence in Switzerland increased from 2007 to 2012, CRC screening coverage remains low and disparities in CRC screening by income persisted over time. These findings highlight the need for increased access to CRC screening as well as enhanced awareness of the benefits of CRC screening in the Swiss population, particularly among low-income residents.

No MeSH data available.


Related in: MedlinePlus

Colorectal Cancer Screening Weighted Prevalence among Respondents Aged 50–75 years of age from Swiss Health Interview Survey 2007–2012.Hemoccult in past 2 years 2007 vs 2012 (p-value = 0.002). Endoscopy in past 10 years 2007 vs 2012 (p-value<0.001). Any CRC screening (Hemoccult in past 2 years or endoscopy in past 10 years or both) 2007 vs 2012 (p-value = 0.036). P-values are adjusted for education, household income, employment, age, sex, marital status, citizenship, urban/rural status, health status and health care use.
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pone.0131205.g001: Colorectal Cancer Screening Weighted Prevalence among Respondents Aged 50–75 years of age from Swiss Health Interview Survey 2007–2012.Hemoccult in past 2 years 2007 vs 2012 (p-value = 0.002). Endoscopy in past 10 years 2007 vs 2012 (p-value<0.001). Any CRC screening (Hemoccult in past 2 years or endoscopy in past 10 years or both) 2007 vs 2012 (p-value = 0.036). P-values are adjusted for education, household income, employment, age, sex, marital status, citizenship, urban/rural status, health status and health care use.

Mentions: Overall, CRC screening from either modality increased from 18.9% in 2007 to 22.2% in 2012 (adjusted p-value = 0.036). (Fig 1) This increase was due to growing endoscopy utilization, which rose from 8.2% in 2007 to 15.0% in 2012 (adjusted p-value <0.001). During the same period, hemoccult utilization decreased from 13.0% to 9.8% (adjusted p-value = 0.002). (Fig 1) The prevalence of CRC screening from either modality was 10% higher in 2012 compared to 2007 (PR = 1.10, 95%CI: 1.01–1.21) after adjusting for socioeconomic as well as demographic, health status and health utilization factors. The adjusted for prevalence of endoscopy was 44% higher in 2012 compared to 2007 (PR = 1.44, 95%CI: 1.26–1.65) whereas the adjusted prevalence of hemoccult use was 18% lower (PR = 0.82, 95%CI: 0.73–0.93).


Colorectal Cancer Screening in Switzerland: Cross-Sectional Trends (2007-2012) in Socioeconomic Disparities.

Fedewa SA, Cullati S, Bouchardy C, Welle I, Burton-Jeangros C, Manor O, Courvoisier DS, Guessous I - PLoS ONE (2015)

Colorectal Cancer Screening Weighted Prevalence among Respondents Aged 50–75 years of age from Swiss Health Interview Survey 2007–2012.Hemoccult in past 2 years 2007 vs 2012 (p-value = 0.002). Endoscopy in past 10 years 2007 vs 2012 (p-value<0.001). Any CRC screening (Hemoccult in past 2 years or endoscopy in past 10 years or both) 2007 vs 2012 (p-value = 0.036). P-values are adjusted for education, household income, employment, age, sex, marital status, citizenship, urban/rural status, health status and health care use.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492507&req=5

pone.0131205.g001: Colorectal Cancer Screening Weighted Prevalence among Respondents Aged 50–75 years of age from Swiss Health Interview Survey 2007–2012.Hemoccult in past 2 years 2007 vs 2012 (p-value = 0.002). Endoscopy in past 10 years 2007 vs 2012 (p-value<0.001). Any CRC screening (Hemoccult in past 2 years or endoscopy in past 10 years or both) 2007 vs 2012 (p-value = 0.036). P-values are adjusted for education, household income, employment, age, sex, marital status, citizenship, urban/rural status, health status and health care use.
Mentions: Overall, CRC screening from either modality increased from 18.9% in 2007 to 22.2% in 2012 (adjusted p-value = 0.036). (Fig 1) This increase was due to growing endoscopy utilization, which rose from 8.2% in 2007 to 15.0% in 2012 (adjusted p-value <0.001). During the same period, hemoccult utilization decreased from 13.0% to 9.8% (adjusted p-value = 0.002). (Fig 1) The prevalence of CRC screening from either modality was 10% higher in 2012 compared to 2007 (PR = 1.10, 95%CI: 1.01–1.21) after adjusting for socioeconomic as well as demographic, health status and health utilization factors. The adjusted for prevalence of endoscopy was 44% higher in 2012 compared to 2007 (PR = 1.44, 95%CI: 1.26–1.65) whereas the adjusted prevalence of hemoccult use was 18% lower (PR = 0.82, 95%CI: 0.73–0.93).

Bottom Line: CRC screening prevalence was greater in the highest income (>$6,000) vs. lowest income (≤$2,000) group in 2007 (24.5% vs. 10.5%, PR:1.37, 95%CI: 0.96-1.96) and in 2012 (28.6% vs. 16.0%, PR:1.45, 95%CI: 1.09-1.92); this disparity did not significantly change over time.While CRC screening prevalence in Switzerland increased from 2007 to 2012, CRC screening coverage remains low and disparities in CRC screening by income persisted over time.These findings highlight the need for increased access to CRC screening as well as enhanced awareness of the benefits of CRC screening in the Swiss population, particularly among low-income residents.

View Article: PubMed Central - PubMed

Affiliation: Emory University, Department of Epidemiology, Atlanta, GA, United States of America; American Cancer Society, Atlanta, GA, United States of America.

ABSTRACT

Background: Despite universal health care coverage, disparities in colorectal cancer (CRC) screening by income in Switzerland have been reported. However, it is not known if these disparities have changed over time. This study examines the association between socioeconomic position and CRC screening in Switzerland between 2007 and 2012.

Methods: Data from the 2007 (n = 5,946) and 2012 (n = 7,224) population-based Swiss Health Interview Survey data (SHIS) were used to evaluate the association between monthly household income, education, and employment with CRC screening, defined as endoscopy in the past 10 years or fecal occult blood test (FOBT) in the past 2 years. Multivariable Poisson regression was used to estimate prevalence ratios (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status, and health utilization.

Results: CRC screening increased from 18.9% in 2007 to 22.2% in 2012 (padjusted: = 0.036). During the corresponding time period, endoscopy increased (8.2% vs. 15.0%, padjusted:<0.001) and FOBT decreased (13.0% vs. 9.8%, padjusted:0.002). CRC screening prevalence was greater in the highest income (>$6,000) vs. lowest income (≤$2,000) group in 2007 (24.5% vs. 10.5%, PR:1.37, 95%CI: 0.96-1.96) and in 2012 (28.6% vs. 16.0%, PR:1.45, 95%CI: 1.09-1.92); this disparity did not significantly change over time.

Conclusions: While CRC screening prevalence in Switzerland increased from 2007 to 2012, CRC screening coverage remains low and disparities in CRC screening by income persisted over time. These findings highlight the need for increased access to CRC screening as well as enhanced awareness of the benefits of CRC screening in the Swiss population, particularly among low-income residents.

No MeSH data available.


Related in: MedlinePlus