Participation In Organized Screening Research Articles

HPV self-sampling in organized cervical cancer screening program: A randomized pilot study in Estonia in 2021.

Cervical cancer incidence in Estonia ranks among the highest in Europe, but screening attendance has remained low. This randomized study aimed to evaluate the impact of opt-in and opt-out human papillomavirus (HPV) self-sampling options on participation in organized screening. A random sample of 25,591 women were drawn from the cervical cancer screening target population who were due to receive a reminder in autumn 2021 and thereafter randomly allocated to two equally sized intervention arms (opt-out and opt-in) receiving a choice between HPV self-sampling or clinician sampling. In the opt-out arm, a self-sampler was sent to home address by regular mail; the opt-in arm received an e-mail containing a link to order a self-sampler online. The remaining 30,102 women in the control group received a standard reminder for conventional screening. Participation by intervention arm, age and region of residence was calculated; a questionnaire was used to assess self-sampling user experience. A significant difference in participation was seen between opt-out (41.7%) (19.8% chose self-sampling and 21.9% clinician sampling), opt-in (34.1%) (7.9% self-sampling, 26.2% clinician sampling) and control group (29.0%, clinician sampling only). All age groups and regions in the intervention arms showed higher participation compared to the control group, but the size of the effect varied. Among self-sampling users, 99% agreed that the device was easy to use and only 3.5% preferred future testing at the clinic. Providing women with a choice between self-sampling and clinician sampling significantly increased participation in cervical cancer screening. Opt-in and opt-out options had a different effect across age groups, suggesting the need to adapt strategies.

Predictive factors for the participation of general practitioners in lung cancer screening by low-dose CT scan in the Somme department in northern France

IntroductionA study on lung cancer screening using low-dose computed tomography (DEP KP80) was conducted in the Somme department in northern France between May 2016 and December 2018. We conducted a cross-sectional survey of family physicians in that department to identify potential predictive factors for their participation in this pilot study. MethodsA survey questionnaire was sent to the 545 general practitioners (GPs) of the Somme department. This survey rendered it possible to identify the investigators who were active in the DEP KP80 study. The questionnaire's content was focused on the socio-demographic conditions of GPs, their professional practices, and their medical practice situations. ResultsThe response rate was 38% (206 completed questionnaires). Active investigators in DEP KP80 accounted for 55% (n=113) of the GPs surveyed, and non-investigators for 45% (n=93). Age, gender, or medical practice situation were not related to the active GPs’ participation in DEP KP80. A multivariate analysis revealed that two factors were correlated with active participation in organized screening: (1) prescription of nicotine replacement therapy; (2) smoking history of the GP. ConclusionsSecuring the active involvement of family physicians and of the French regional cancer screening coordination centers seems essential for the future organization of lung cancer screening on a regional or national level. Our results demonstrate that incorporating smoking cessation support structures into the program would maximize the mechanism's potential.

Colorectal cancer screening in primary care pharmacy in Corsica: a support for the prevention in general medicine

Colorectal cancer (CRC) affects approximately 43,000 people each year in France and is responsible for nearly 18,000 deaths a year. The national organized screening program contributes to its early detection. The test is available to the preferred GP or, to the Regional Center in charge of the invited public. Often the process of going to his doctor to get the test is not well accepted and the participation in organized screening is low. Our project aims to evaluate the impact of the provision of this test in pharmacies on screening for colorectal cancer in Corsica. The article describes the method used to mobilize the primary care pharmacists of the territory, provide them the test kits and follow-up of the people who took part in the test. The results presented highlight a very positive impact of the experiment with a progression of the realized rate to 36% over the period of 9 months.

Role of participation in organized screening on the survival of women with breast cancer according to socioeconomic disparities: A population-based study

Several observational studies have suggested the impact of socioeconomic disparities in breast cancer diagnosis. Living in a deprived area was associated to advanced tumor stage at diagnosis and poor prognosis. The participation in organized breast cancer screening (OBCS) program can help to detect cancers at an early stage and to reduce mortality. This study aimed at describing survival of women with cancer according to their participation in OBCS and socioeconomic characteristics in the department of Gironde. All cases of breast cancer in situ or invasive diagnosed over the period 2008–2010, in women aged 50 to 74 years were extracted from Gironde Cancer Registry. The participation in OBCS program was obtained from the Gironde Screening Coordination Structure (AGIDECA). Women were categorized in 4 groups according their participation in the OBCS. The socioeconomic environment was measured by an aggregated indicator of deprivation: the French European Deprivation Index (EDI). EDI was categorized in quintiles (quintile 1: women most affluent and quintile 5: women most deprived). We estimated net survival rates at 1 and 5 years using the Pohar-Perme method according to the participation in OBCS and socioeconomic deprivation. A correction of the advance bias at diagnosis (or lead time bias) was taken into account by modifying the survival time of the screened women according a method established by Duffy et al. During the 2008–2010 period, 2,244 women were diagnosed with first breast cancer in Gironde department. In this population, 297 deaths were reported. Among all these women, 57% had participated in OBCS, 24% were non-screened, 14% had interval cancer (cancer diagnosed between 2 screening test) and 5% were diagnosed more than 2 years after the last screening test. Net survival was higher in the group of screen-detected women compared to non-screened women (97.3% vs. 83.8%, P < 0.0001). Non-screened women had lower net survival when they were deprived (quintile 1: 91.1% vs. quintile 5: 78.1%, P < 0.0106). Taking into account socioeconomic disparities, survival was higher for screened women than for non-screened women, but the difference was significant only in most deprived areas (quintiles 3 to 5). After correction for the bias in advance of diagnosis, the survival rates of screen-detected women were lower than without correction, but they remained higher than those of women who were not screened. Women with breast cancer participating in OBCS in Gironde had better net survival at five years compared to women who were non-screened. The role of OBCS on breast cancer survival seemed to be stronger for women in most deprived areas. The implementation of incentive actions in deprived areas in order to foster women to participate in OBCS could improve their survival in case of breast cancer diagnosis.

Impact of organized and opportunistic Pap testing on the risk of cervical cancer in young women - A case-control study from Finland.

Effectiveness of organized cervical cancer screening has been shown in several studies. However, screening among women aged <25years has been suggested to have little or no impact on the risk of cervical cancer. Also the significance of opportunistic testing in preventing cervical cancer is unclear. The aim of this study was to clarify the effect of opportunistic testing and organized screening on the risk of cervical cancer among young Finnish women. In the Finnish Cancer Registry there were 284 cervical cancer cases diagnosed and tested below the age of 40 in 2004-2009. Screening histories and data on opportunistic testing for these women and their 1698 age-matched controls were derived from databases of the Mass Screening Registry and The National Institute for Health and Welfare from 1997 onward. OR's and 95% CI's for the association of cervical cancer diagnosis and participation in organized screening and opportunistic testing were estimated using unconditional logistic regression. Results were corrected for self-selection bias and attendance rate. Among women aged under 25, OR of cervical cancer for any Pap test taken 0.5-5.5years before diagnosis was 1.25 (95% CI 0.46-3.43). Attending only organized screening at age 25-39 resulted in OR 0.52 (0.36-0.77), attending only opportunistic testing in OR 0.86 (0.60-1.25) and attending both in OR 0.48 (0.29-0.79). Opportunistic testing showed no clear additional benefit on preventing cervical cancer. The study also supports findings on a smaller effect of screening in younger age groups.

Do fears of getting cancer and family history of cancer influence participation in opportunistic screening or organized screening for gastric cancer?

e13045 Background: Cancer is the leading cause of death in Korea. Individuals with a family history of cancer might overestimate their personal risk for getting cancer and report high cancer-related worry or concern. Those factors could positively or negatively influence on cancer screening behavior. Although Korea has a universal screening program for common cancers, some people still choose opportunistic screening program with out-of-pocket costs. This study was to identify association between fears of getting cancer and participation on opportunistic anc organized screening programs for cancer. Methods: The study population was derived from the Korean National Cancer Screening Survey 2013, which is annual survey conducted by National Cancer Center of Korea in order to investigate trends of participation rates among general population in cancer screening. 3,004 individuals aged over 40 years were finally selected as study subjects. Chi-square tests and multinomial logistic regression model were used to identify factors associated with being screened for gastric cancer. Results: A total of 2,078 of the subjects (69.2%) underwent gastric cancer screening, of which 311 individuals (10.4%) participated in opportunistic and 1,767 individuals (58.8%) participated in organized screening programs. After adjusting socio-demographic factors and health behaviors, worry and concern about cancer were identified as factors positively associated with being screened for gastric cancer. ORs for undergoing gastric cancer screening were elevated for both screening programs according to the level of worry and concern about cancer (p for trend &lt; 0.05). We did not found relationship between family history of gastric cancer and participation. Conclusions: The results of this study suggest that fears of getting cancer such as worry and concerned about cancer had a stronger influence on participation in not only organized screening program but also opportunistic screening program. We could identify that ORs for undergoing the opportunistic screening were slightly higher than those for undergoing the organized screening in terms of cancer worry and cancer concern.

Canadian cancer screening disparities: a recent historical perspective.

Across Canada, introduction of the Pap test for cervical cancer screening, followed by mammography for breast cancer screening and, more recently, the fecal occult blood test for colorectal cancer screening, has contributed to a reduction in cancer mortality. However, another contribution of screening has been disparities in cancer mortality between certain populations. Here, we explore the disparities associated with breast and cervical cancer screening and preliminary data concerning disparities in colorectal cancer screening. Although some disparities in screening utilization have been successfully reduced over time (for example, mammography and Pap test screening in rural and remote populations), screening utilization data for other populations (for example, low-income groups) clearly indicate that disparities have existed and continue to exist across Canada. Organized screening programs in Canada have been able to successfully engage 80% of women for regular cervical cancer screening and 70% of women for regular mammography screening, but of the women who remain to be reached or engaged in regular screening, those with the least resources, those who are the most isolated, and those who are least culturally integrated into Canadian society as a whole are over-represented. Population differences are also observed for utilization of colorectal cancer screening services. The research literature on interventions to promote screening utilization provides some evidence about what can be done to increase participation in organized screening by vulnerable populations. Adaption and adoption of evidence-based screening promotion interventions can increase the utilization of available screening services by populations that have experienced the greatest burden of disease with the least access to screening services.

Réticences au dépistage organisé du cancer du sein dans les Yvelines

ObjectivesWomen's participation in organized screening of breast cancer was 52% in France and 40% in the Île de France in 2010. We wanted to investigate the reasons for non-participation in the screening program and the reluctance of women to it at the level of a department in Île de France. Materials and MethodsAn anonymous questionnaire was sent to non-respondents in organized screening for breast cancer in the Yvelines department in September 2011 on the occasion of the event “Octobre Rose”, month of national mobilization for mass screening for breast cancer. The analysis of these questionnaires was used to determine the causes of non-adherence to organized screening and reluctance to it. We compared the questionnaire responses in the characteristics of patients attending an individual screening with those of patients without any screening. ResultsTwo thousand nine hundred and ninety-two questionnaires were sent and 3026 responses received (10%). Two thousand six hundred and fifteen women (86%) reported regular screening and make mammograms every two years while 411 (14%) reported occasional or no screening. About the reluctance to conduct the review, the lack of time, the bad memories of a previous mammogram and the fear of pain were the predominant brakes. Nearly 50% of women do not participate in screening because they did not consider themselves at risk for various reasons (lack of symptoms, healthy lifestyle and no family history) and 22% of women surveyed had an attitude of denial cope with the disease. The typical profile of women performing individual or organized screening of breast cancer was that young, single, working, of low socio-professional category and rarely attending their general practitioner or gynaecologist. Health-care professionals seem most likely to cause adherence to screening for breast cancer. Discussion and conclusionFocusing on the poor communication and promote organized screening instead of individual screening by health-care professionals themselves could increase adherence to organized screening in the Yvelines.

Factors associated with organized and opportunistic cancer screening: Results of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2011.

Cancer is one of the leading causes of death in Korea. To reduce cancer incidence, the Korean National Cancer Center (KNCC) has been expanding its organized cancer screening program. In addition, there are opportunistic screening programs that can be chosen by individuals or their healthcare providers. The purpose of this study was to investigate factors associated with participation in organized and opportunistic cancer screening programs, with a particular focus on socioeconomic factors. We used data from the Korea National Health and Nutrition Examination Survey (KNHANES), a cross-sectional nationwide study conducted by the Korean Ministry of Health and Welfare from 2007 to 2011. The study included information from 9,708 men and 12,739 women aged 19 years or over. Multinomial logistic regression analysis was conducted, adjusting for age, year of data collection, residential region, current smoking status, current alcohol consumption status, exercise, marriage status, job status, perceived health status, stress level, BMI, limitation of activities, cancer history, health insurance type, and private insurance status, to investigate the association between education level, economic status, and cancer screening participation. In terms of education level, disparities in attendance were observed only for the opportunistic screening program. In contrast, there was no association between education level and participation in organized screening. In terms of economic status, disparities in opportunistic screening participation were observed at all income levels, but disparities in organized screening participation were observed only at the highest income level. Our findings reveal that socioeconomic factors, including educational level and economic status, were not significantly associated with participation in organized cancer screening, except at the highest level of income.

Understanding barriers to organized breast cancer screening in France: women's perceptions, attitudes, and knowledge

The participation rate in organized breast cancer screening in France is lower than recommended. Non-participants either use opportunistic screening or do not use either screening modality. To assess any differences in perceptions, attitudes and knowledge related to breast cancer screening between users of opportunistic screening and non-users of any screening mammograms and to identify potential barriers to participation in organized screening. Six focus groups were conducted in May 2010 with 34 French non-participants in organized screening, 15 who used opportunistic screening (OpS group) and 19 who used no screening (NoS group). The guide used for both groups explored perceptions and attitudes related to health, cancer and screening; perceptions of femininity; and knowledge about breast cancer screening. Thematic content analysis was performed. Perceptions, attitudes and knowledge differed between the two groups. Women in the OpS group perceived a high susceptibility to breast cancer, visited their gynaecologist regularly, were unfamiliar with organized screening modalities and had doubts about its quality. NoS women had very high- or low-perceived susceptibility to breast cancer, knew about screening modalities, had doubts about its usefulness and expressed negative opinions of mammograms. Differences in perceptions and attitudes related to breast cancer screening partially explain why some women choose opportunistic screening or no screening. General practitioners and gynaecologists are in a unique position to provide individually tailored preventative messages to improve participation in organized screening.

Age-Specific Effectiveness of the Finnish Cervical Cancer Screening Programme

There is currently some uncertainty about the effectiveness of screening outside the established core ages of 30 to 60. We audited the screening histories of cervical cancers and conducted a case-control evaluation of the effectiveness of organized screening in different ages. Screening histories for 1,546 cervical cancer cases and 9,276 age-matched controls were derived by linkage to the screening register. ORs and 95% confidence intervals (CI) for the association of participation in a program screen and cervical cancer diagnosis in the following screening interval were estimated using conditional logistic regression and corrected for self-selection bias. Participation in a single screen was associated with a 47% decrease in cervical cancers, but this effect was age-dependent. Screening at 25 showed little or no impact on the risk of cervical cancer in the next interval, whereas screens at 40 to 65 showed protective effects of 51% to 66%. Program screening at the age of 25 is not associated with a reduced risk of cervical cancer in the following screening interval. Additional analyses are needed that also take opportunistic screening of women during the first rounds of organized screening into consideration. In contrast, screening yields substantial risk reductions in older ages at least up to the age of 60. This study also provides moderate indication of a long-lasting risk reduction associated with screening at the age of 65. Cervical cancer screening effectiveness is for the first time evaluated at different ages up to 65 with correction for self-selection bias of participation in organized screening.

Trends in Socioeconomic Disparities in Organized and Opportunistic Gastric Cancer Screening in Korea (2005-2009)

A growth of consensus and increasing activities related to organized cancer screening programs has occurred in Korea since 1999. It is important to assess disparities in the fight against cancer, and it is crucial to identify particular groups that may be experiencing a high burden of cancer-related illness. Data from 8,160 men and women ages >40 years from the 2005 to 2009 Korean National Cancer Screening Survey were used to analyze the relationship between socioeconomic position and receiving upper gastrointestinal series or upper endoscopy within the past 2 years. We used absolute and relative concentration indexes, that is, summary measures of disparity based on both rate differences and rate ratios. For organized screening, the education disparity declined, but the income disparity index increased, indicating that participation in organized screening was relatively more concentrated among the lower-income groups. For opportunistic screening, income and education disparities increased due to the widening of socioeconomic differences. The results of this study suggested progress toward socioeconomic disparity-related goals in organized screening for gastric cancer. However, the income disparity trends in organized screening may change in a manner similar to those in opportunistic screening in the future because of the much faster rate of organized screening uptake by those higher on the socioeconomic scale. This study addresses the routine monitoring of coverage of screening among different socioeconomic groups and could be used to inform policies to reduce disparity in coverage.

Screening history of women with invasive cervical cancer in north-east Italy

Objectives To describe screening histories of women with invasive cervical cancer (ICC) in Friuli Venezia Giulia, after the introduction of organized screening, in order to identify possible reasons undermining prevention of ICC. To investigate associations between screening histories in relation to women's survival and tumor characteristics, with a focus on organized and opportunistic screenings. Study design 438 women, diagnosed with ICC between 1999 and 2005, were identified using the regional Cancer Registry. Cytological and histopathological information were obtained through regional health databases. Associations between different screening histories and characteristics of women and their tumors were evaluated by means of odds ratios (OR) and corresponding 95% confidence intervals (CI), through multinomial logistic regression models adjusted for age; death risks were estimated by computing hazard ratios (HR) with 95% CI, using Cox models adjusted for age, tumor stage, and histology. Results 165 (38%) women with ICC had no Pap smears: 71 (16%) never attended the organized screening despite invitation; 69 (16%) were never invited because they were above 64 years of age; and 25 (6%) were yet to be invited. Conversely, 273 (62%) women underwent screening: 141 women (32%) had opportunistic screening; 132 (30%) women attended the organized program. A total of 193 (44%) women had ICC detected at screening. Compared to women with ICC who had never been screened, those screened within the organized program were more often at stage IA (46%), were seldom at stage II or higher (OR = 0.3, 95% CI: 0.1–0.6, vs. IB), and showed a lower risk of death (HR = 0.6, 95% CI: 0.3–1.0). Conclusions In Friuli Venezia Giulia, the lack of screening among older women and of compliance with organized programs among women in the target population are the main limitations in cervical cancer secondary prevention. Our findings indicate that participation in organized screening has a beneficial effect in terms of down-staging and improved survival as compared to both absence of screening and opportunistic screening.