Inequalities in colorectal cancer screening participation in the first round of the national screening programme in England

von Wagner, C; Good, A; Wright, D; Rachet, B; Obichere, A; Bloom, S; Wardle, J; (2009) Inequalities in colorectal cancer screening participation in the first round of the national screening programme in England. British journal of cancer, 101. S60-S63. ISSN 0007-0920 DOI:

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BACKGROUND: Introduction of organised, population-based, colorectal cancer screening in the United Kingdom using the faecal occult blood test (FOBT) has the potential to reduce overall colorectal cancer mortality. However, socio-economic variation in screening participation could exacerbate existing inequalities in mortality. METHODS: This study examined FOBT uptake rates in London, England in relation to area-level socio-economic deprivation over the first 30 months of the programme during which 401 197 individuals were sent an FOBT kit. Uptake was defined as return of a completed test kit within 3 months. Area-level deprivation in each postcode sector was indexed with the Townsend Material Deprivation Index. Analyses controlled for area-level household mobility, ethnic diversity and poor health, each of which was associated with lower return rates. RESULTS: The results showed a strong socio-economic gradient in FOBT uptake, which declined from 49% in the least deprived quintile of postcodes to 38% in the middle quintile and 32% in the most deprived quintile. Variation in socio-economic deprivation between sectors accounted for 62% of the variance in return rates, with little attenuation as a result of controlling for ethnic diversity, household mobility or health status. CONCLUSION: These results highlight the need to understand the causes of socio-economic gradients in screening participation and address barriers that could otherwise increase disparities in colorectal cancer survival. British Journal of Cancer (2009) 101, S60-S63. doi: 10.1038/sj.bjc.6605392 (C) 2009 Cancer Research UK

Item Type: Article
Keywords: colorectal cancer screening, socio-economic status, ethnicity, self-reported health, health inequality, socioeconomic differences, survival, predictors, wales, Colorectal Neoplasms, diagnosis, mortality, prevention & control, Early Detection of Cancer, England, Humans, Mass Screening, Occult Blood, Socioeconomic Factors
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Non-Communicable Disease Epidemiology
Research Centre: Cancer Survival Group
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 19956165
Web of Science ID: 273523000011


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