Factors influencing organized populational screening for colorectal cancer in the Lisbon and Tagus Valley Health Region: a six-year analysis of demographic and organizational influences
DOI:
https://doi.org/10.32385/rpmgf.v41i6.14060Keywords:
Mass screening, Colorectal cancer, Cancer sreening tests, Health equity, Health services accessibilityAbstract
Introduction: Colorectal cancer (CRC) ranks third among malignant neoplasms in Portugal, emphasizing the importance of early detection. The initiation of a population-based CRC screening program (CRCSP) in the Lisbon and Tagus Valley Health Region (LTVHR) in 2017 prompted this study to assess and inform health policies. It aims to identify associations between screening participation outcomes, user geodemographics, and organizational features (2017-2022).
Methods: This cross-sectional study analysed 87,223 users aged 50 to 74 undergoing CRCSP in LTVHR, in 3 rounds (2017-2018, 2019-2020, and 2021-2022). We compared screening uptake and test results across sex, age, health centre grouping, unit type, and family physician assignment using chi-square tests and adjusted relative frequency ratios (RFa) derived from a generalized linear model.
Results: Screening participation differed by sex, with a 5.8% higher rate in women (RFa 1.058; CI1.047-1.068). Younger groups exhibited lower adherence, with those aged 50-54, 55-59, and 60-64 showing RFa of 0.826, 0.887, and 0.968, respectively. Family Health Units (FHU) and users with a Family Physician (FP) showed higher participation rates. There was a 37.7% higher RFa in the 1st-round screenings and a 31.4% lower RFa in the 2nd-round. Positivity rates varied among Health Centres Grouping (HCG), with no differences by health unit type or FP assignment. Most screened users belonged to specific HCG (63.6%), particularly HCG 1, indicating potential organizational influences.
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