Sociodemographic predictors of participation in colorectal cancer screening

PurposeColorectal cancer screening by inviting citizens tocomplete a test for blood in faeces was initiated in Denmarkin 2014. We have examined sociodemographic predictors thatinfluence participation to identify factors that could betargeted to increase compliance.MethodsNational registers were used to link data on invita-tions for colorectal cancer screening in Denmark from 2014 to2015. Region of residence, age, gender, immigration status,income, educational level and marital status were identified.Logistic regression analysis was used to estimate the risk ofnon-participation for invited citizens while adjusting for allother sociodemographic variables.ResultsA total of 854,237 individuals were included in theanalysis. The national participation proportion was 65.33%,with significant differences between sociodemographicgroups. Participation proportions were the lowest in non-Western immigrants (53.00%), individuals without a partner(54.05%) and those in the lowest income quartile (54.65%),with subgroup participation as low as 40.56%. The highestparticipation proportion was seen in individuals in the highestincome quartile (71.56%). Region of residence, age, gender,educational level, income quartile, marital status and immigra-tion status all had statistically significant independent differ-ences in risk of non-participation after full model adjustment.ConclusionParticipation in colorectal cancer screening washigh in Denmark in 2014 and 2015. Large differences in par-ticipation were seen between sociodemographic subgroups,potentially resulting in social inequality in the benefits fromscreening. Future efforts to increase participation should focuson the low compliance subgroups, such as singles, non-Western immigrants and people from the lowest socioeco-nomic groups.