Inequality in uptake of bowel cancer screening by deprivation, ethnicity and smoking status: cross-sectional study in 86 850 citizens

Alexandra Creavin*, Sam Creavin, Charlie Kenward, Jonathan Sterne, Jo Williams

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Background
Survival from colorectal cancer depends on stage at detection. In England, bowel cancer mortality has historically been highest in deprived areas. During the initial stages of the COVID-19 pandemic, it was necessary to temporarily halt many screening programmes, which may have led to inequalities in uptake since screening restarted.

Methods
Cross-sectional data from the Bristol, North Somerset and South Gloucestershire Systemwide Dataset were analyzed. Associations of baseline characteristics with uptake of bowel screening were examined using logistic regression.

Results
Amongst 86 850 eligible adults aged 60–74 years, 5261 had no screening record. There was little evidence of association between no screening and sex (adjusted odds ratio 0.95 (95% confidence interval 0.90, 1.02)). Absence of screening record was associated with deprivation (1.26 (1.14, 1.40) for the most compared with the least deprived groups), smoking (1.11 (1.04, 1.18)) compared with no smoking record and black (1.36 (1.09, 1.70)) and mixed (1.08 (1.01, 1.15)) ethnicity compared with white ethnicity.

Conclusions
In a data set covering a whole NHS Integrated Care Board, there was evidence of lower uptake of bowel cancer screening in adults living in more deprived areas, of minority ethnic groups and who smoked. These findings may help focus community engagement work and inform research aimed at reducing inequalities.
Original languageEnglish
Article numberfdad179
Pages (from-to)904-911
Number of pages8
JournalJournal of Public Health (United Kingdom)
Volume45
Issue number4
DOIs
Publication statusPublished - 20 Sept 2023

Bibliographical note

Funding Information:
Alexandra Creavin, Clinical Doctoral Research Fellow, DRF 2015-08-108-R128022-101, is funded by the National Institute for Health Research (NIHR) for this research project. Sam Creavin, Academic Clinical Lecturer, is funded by the NIHR for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, BNSSG Integrated Care Board, NHS or the UK Department of Health and Social Care.

Funding Information:
Alexandra Creavin, Clinical Doctoral Research Fellow, DRF 2015-08-108-R128022-101, is funded by the National Institute for Health Research (NIHR) for this research project. Sam Creavin, Academic Clinical Lecturer, is funded by the NIHR for this research project. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR, BNSSG Integrated Care Board, NHS or the UK Department of Health and Social Care.

Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.

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