Participation In Screening Research Articles

Impact of financial literacy and education on breast and cervical cancer screening participation in Japan.

Despite government efforts, the uptake of screening for breast and cervical cancers among Japanese women remains low. This study employs financial literacy and financial education as proxies for rational decision-making to explore their potential to enhance cancer screening practices in Japan. Using data from Osaka University's Preference Parameters Study, mean comparison tests and probit regression models are utilized to examine the association between breast and cervical cancer screening and financial literacy and financial education. The results of probit regression show that individuals with higher levels of financial education tend to participate in both breast and cervical cancer screening. In contrast, individuals with higher financial literacy are likely to participate in breast cancer screening, whereas no significant impact is observed for cervical cancer screening. Furthermore, our findings reveal that financial education positively influences both breast and cervical cancer screening. Factors such as employment, marriage, higher education, increased household income, and greater assets demonstrate robust positive relationships with breast and cervical cancer screening. Meanwhile, psychological factors including happiness, a myopic view of the future, anxiety about later life, and perceived health status have no significant associations, except for a positive association between anxiety about life and cervical cancer screening. Our study suggests the development of targeted educational programs that leverage financial literacy and financial education to raise awareness about the importance of breast and cervical cancer screening.

Efficacy of Interventions Intended to Increase Lung Cancer Screening Rates: A Systematic Review and Meta-analysis.

Few eligible patients in the United States participate in lung cancer screening (LCS) with low-dose computed tomography (LDCT). What is the efficacy of interventions to increase LCS participation? We performed a systematic review following a prespecified protocol registered in PROSPERO (CRD42021283984). In June/July of 2021, we searched Ovid MEDLINE, Embase, Cochrane, CENTRAL, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and Epistemonikos from 1946 to October 2021 to identify studies evaluating interventions to increase LCS participation. Thirteen of 2761 studies met inclusion criteria for data extraction. Of these, six had results available (five RCTs and one prospective observational study). The studies had predominantly White and non-Hispanic participants. An intention-to-treat analysis was used to calculate each study's relative risk (RR) to increase LCS. Effect sizes were pooled using a random-effects model with a subgroup analysis for multi- versus single-step interventions. Risk of bias was evaluated with the revised Cochrane risk-of-bias tool (RoB 2) and risk of bias in non-randomized studies of interventions (ROBINS-I). Overall, the proportion of screening LDCTs performed did not improve in the intervention group relative to the comparator group (RR [95% CI] of 1.30 [0.74, 2.29]), and meta-analysis indicated high heterogeneity of studies (I2 = 91%). Subgroup analysis suggests that interventions targeting multiple barriers may increase LCS participation (RR [95% CI] for multistep vs single-step; 2.68 [1.77, 4.05] vs 0.99 [0.89, 1.10], P < 0.01). Quality assessment revealed that three of five RCTs showed some concerns or high risk of bias. Evidence on efficacy of interventions to increase LCS participation is limited due to a small number of prospective studies performed in non-diverse populations with critical risk of bias. Further, overall, studied interventions did not improve lung cancer screening participation, though interventions targeting multiple barriers may have some benefit.

Cancer Risk Among Patients With Multiple Sclerosis: A 10-Year Nationwide Retrospective Cohort Study.

Previous literature has been diverging on cancer risk in people with multiple sclerosis (PwMS). Therefore, this study compared the risk of cancer in PwMS and a matched sample from the French general population. This 10-year nationwide retrospective matched cohort study (2012-2021) used data from the national French administrative health care database (99% coverage of the French population) to determine the time to the first incident cancer. PwMS were identified using their long-term disease (LTD) status, hospitalizations, and multiple sclerosis (MS)-specific drug reimbursements. The control population was matched 4:1 on age, sex, residence, insurance scheme, and cohort entry date. Participants were included if they had no history of cancer in the 3 years before inclusion. Patients with cancer were identified through LTD status, hospitalizations, chemotherapy, radiotherapy, or prostate cancer-specific drug reimbursements. Overall and cancer location-specific hazard ratios (HRs) for the first incident cancer were obtained from Fine and Gray models, and age- and sex-stratified estimates were reported. Participation in cancer screening through the 3 national programs (breast, colorectal, and cervical) were compared between groups. Cancer incidence was 799 per 100,000 person-years (PYs) (n = 8,368) among the 140,649 PwMS and 736 per 100,000 PYs (n = 31,796) among the 562,596 matched controls (70.8% of women; follow-up: 7.6 ± 3.2 years). A small overall risk increase was observed for PwMS (HR 1.06, 95% CI 1.03-1.08), mostly in women (HR 1.08, 95% CI 1.05-1.11). Risk varied by cancer types and was lower for prostate (HR 0.80, 95% CI 0.73-0.88), breast (HR 0.91, 95% CI 0.86-0.95), and colorectal (HR 0.90, 95% CI 0.84-0.97) cancer and higher for bladder (HR 1.71, 95% CI 1.54-1.89), brain (HR 1.68, 95% CI 1.42-1.98), and cervical (HR 1.24, 95% CI 1.12-1.38) cancer in PwMS. Cancer risk was higher in PwMS younger than 55 years (HR 1.20, 95% CI 1.15-1.24) but decreased in PwMS aged 65 years and older (HR 0.89, 95% CI 0.85-0.94). This trend was found in all cancer locations. There were fewer PwMS getting screened than controls (all programs), with a particularly pronounced difference among those aged 65 years and older. Cancer risk was slightly increased in PwMS, particularly for urogenital cancers, possibly due to surveillance bias. Risk fluctuated depending on age, perhaps due to varying generational screening practices (i.e., diagnosis neglect in the older PwMS) and risk factors.

Disability and Participation in Colorectal Cancer Screening: A Systematic Review and Meta-Analysis

Background: The aim of this study is to assess the impact of disability on participation in CRC screening and to determine the overall effect size. Methods: We conducted a systematic review and meta-analysis to compare CRC screening participation in individuals with and without disabilities. The search encompassed five databases (PubMed, EMBASE, Scopus, Google Scholar, medRxiv). Pooled estimates were calculated for each type of CRC screening and disability categories to synthesize the findings. The participation in CRC screening was derived using a random effects model. Results: A total of 20 articles were included, most of them from the USA. Based on pooled estimates, individuals with disabilities have lower odds of undergoing CRC screening versus those without disabilities (OR = 0.80, 95%CI 0.73–0.87). Analysis by screening type indicated that individuals with a disability have lower odds of a fecal occult blood test or a fecal immunochemical test (OR: 0.72, 95%CI 0.65–0.81), with no significant difference for a colonoscopy. Individuals with intellectual disabilities had significantly lower rates of CRC screening participation (OR = 0.65, 95%CI 0.53–0.79), especially for FOBT/FIT (OR = 0.58, 95%CI 0.49–0.69). Conclusions: Disparities exist for CRC screening participation in people with disabilities. Further research and coordinated efforts are essential to develop interventions for improving early cancer diagnosis for this non-negligible patient group.

Knowledge and practice of early gastric cancer screening among adults aged ≥ 45 years in China: a cross-sectional study

BackgroundAs the incidence of gastric cancer increases sharply in adults aged over 45 years, a better understanding of gastric cancer screening knowledge and practice is crucial to promote cancer-screening services. This study aimed to evaluate knowledge of early gastric cancer screening, adherence to screening, and perceived barriers hindering screening practices among adults aged ≥ 45 years in China.MethodsA multi-center, face-to-face, cross-sectional study was conducted in community sites in Shijiazhuang, China, through the distribution of structured questionnaires from August to September, 2022.ResultsOf the 1053 respondents, only 13.4% demonstrated a good understanding of early gastric cancer screening. While 64.0% knew that gastroscopy is the gold standard for screening (“how to screen”), only 19.9% were aware of the recommended starting age (“when to screen”). Moreover, less than half could correctly identify high-risk groups (“whom to screen”), with awareness ranging from 20.5% for those infected with H. pylori to 47.8% for those with gastric diseases. Independent factors related to higher screening knowledge included female sex (OR = 1.55, 95% CI = 1.01–2.38), higher education level (OR = 4.03, 95% CI = 2.68–6.06), being with a personal/family experience of gastric diseases (OR = 1.68, 95% CI = 1.12–2.52). In addition, only 23.4% of respondents underwent GC screening. The dominant barrier to early screening was the “absence of symptoms or signs”, followed by “fearing procedural discomfort”.ConclusionThis study highlights significant gaps in early gastric cancer screening knowledge and participation among middle-aged and elderly individuals in China. Addressing these gaps through culturally tailored health education campaigns is a critical strategy for increasing public awareness and participation.

Downstream healthcare use following breast cancer screening: a register-based cohort study

BackgroundFor evaluation of breast cancer screening and informed prioritisation, it is important to examine the downstream healthcare use associated to participation. The objective of this study is to determine the...

Gender, race, and economic factors influencing screening practices in hidradenitis suppurativa: a cross-sectional analysis.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that significantly impacts patients' quality of life. Despite its substantial burden, HS remains underdiagnosed and undertreated, particularly among marginalized populations. This study aimed to elucidate the primary social determinants of health (SDOH) and structural determinants of health (StDOH) influencing rates and patterns of screening for patients diagnosed with HS. Using data from the All of Us Research Program database, participants with HS were identified using ICD-10 codes and stratified based on various sociodemographic factors, including race, gender, and income. The primary outcome variables were participation in viral screening and disease screening among HS patients. Statistical analyses were performed to assess the relationship between sociodemographic factors and screening practices. Income and gender had significant impacts on screening practices. Higher-income patients were more likely to receive necessary disease screening and less likely to receive unnecessary disease screening compared to lower-income patients. Non-male patients had significantly higher rates of unnecessary disease and viral screening than male patients. While differences in screening practices within each income level were significant, there were no significant differences across different income brackets or racial groups. These findings suggest that subjectivity associated with individual physicians' recommendations may contribute to disparities in screening outcomes, especially in lower-income and non-male HS patients. The study highlights the need for more clearly delineated screening guidelines and continued research on the role of SDOH in improving patient health outcomes.

Key contextual factors involved with participation in medical and genomic screening and research for African American and White Americans: a qualitative inquiry.

Tremendous progress has been made promoting diversity in recruitment for genomic research, yet challenges remain for several racial demographics. Research has cited intertwined fears of racial discrimination and medical mistrust as contributing factors. This study aimed to identify key factors to establishing trust in medical and genomic screening and research among African Americans and White Americans. Participants completed online focus groups and resulting transcripts were analyzed using a qualitative descriptive approach, with content analysis methods based on recommendations by Schreier. Fifteen African Americans and twenty-three White Americans participated in the study, 63% of which were female. The mean age of participants was 38.5 (SD = 16.6). The Overarching Theme of Trust is Context Dependent was identified, along with the following five themes describing elements influencing trustworthiness for our participants: (1) Professional Experience, Education, and Training Bolster Trust; (2) Trust Depends on Relationships; (3) Cross-checking Provided Information is Influential in Establishing Trust; (4) Trust is Undermined by Lack of Objectivity and Bias; and (5) Racism is an Embedded Concern and a Medical Trust Limiting Component for African Americans. To effectively address mistrust and promote recruitment of diverse participants, genomic research initiatives must be communicated in a manner that resonates with the specific diverse communities targeted. Our results suggest key factors influencing trust that should be attended to if we are to promote equity appropriately and respectfully by engaging diverse populations in genomic research.

Assessing Barriers and Facilitators to Participation in a Nurse-Driven, Opt-Out HIV Screening Program in the Emergency Department

Emergency department (ED) HIV screening is a key component of the strategy to end the HIV epidemic, reaching populations with limited access to care for screening and early diagnosis. Many screening programs rely primarily on participation from ED nurses; however, little is known about the factors affecting nurse participation in screening. Guided by the Consolidated Framework for Implementation Research, 20 semi-structured interviews were conducted with ED nurses to explore perceptions of HIV screening, barriers and facilitators to participation, and implementation insights. Nurses were categorized as either high adopters or low adopters based on the number of HIV tests ordered 3 months prior to interviews. The Stanford Lightning Report Method, a rapid qualitative analysis approach, was used to analyze field notes. All participants generally agreed that the ED was an appropriate location for screening and that frequent, multimodal education about screening was needed. Integration of screening into standard workflows, education about the public health impact of screening, and the use of peer champions and mentors were identified as important strategies to increase participation. By incorporating these findings into implementation strategies, EDs may be able to increase nurse participation in screening, addressing important health equity issues in HIV diagnosis.

Addressing Underscreening for Cervical Cancer among South Asian Women: Using Concept Mapping to Compare Service Provider and Service User Perspectives of Cervical Screening in Ontario, Canada

Cervical cancer is largely preventable through screening and treatment of cervical lesions. In the province of Ontario, South Asian women have some of the lowest rates of screening. The roles of service providers—those in healthcare and community services—and their interactions with screen-eligible people can greatly impact the uptake of screening. In our study, we used concept mapping (CM) to engage over 70 South Asian service users (i.e., those eligible for cervical screening) and service providers to identify a range of ideas and experiences that impact uptake of cervical screening for South Asian women, which were then rated by 45 participants in terms of ‘importance’ and ‘ease to address’ to encourage participation in cervical screening. Overall, ideas related to knowledge and education were rated as most important and easiest to address by both groups. Some differences were seen with South Asian service users valuing the importance of addressing ‘cultural beliefs and influences specific to sexual health’ more than service providers, while service providers valued the importance of addressing ‘lack of comfort and supportive relationships’ more than South Asian service users. Future interventions should target the knowledge and education needs of service users and increase service providers’ awareness of cultural beliefs and influences specific to sexual health.

Electronic Health Interventions and Cervical Cancer Screening: Systematic Review and Meta-Analysis.

Cervical cancer is a significant cause of mortality in women. Although screening has reduced cervical cancer mortality, screening rates remain suboptimal. Electronic health interventions emerge as promising strategies to effectively tackle this issue. This systematic review and meta-analysis aimed to determine the effectiveness of electronic health interventions in cervical cancer screening. On December 29, 2023, we performed an extensive search for randomized controlled trials evaluating electronic health interventions to promote cervical cancer screening in adults. The search covered multiple databases, including MEDLINE, the Cochrane Central Registry of Controlled Trials, Embase, PsycINFO, PubMed, Scopus, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature. These studies examined the effectiveness of electronic health interventions on cervical cancer screening. Studies published between 2013 and 2022 were included. Two independent reviewers evaluated the titles, abstracts, and full-text publications, also assessing the risk of bias using the Cochrane Risk of Bias 2 tool. Subgroup analysis was conducted based on subjects, intervention type, and economic level. The Mantel-Haenszel method was used within a random-effects model to pool the relative risk of participation in cervical cancer screening. A screening of 713 records identified 14 articles (15 studies) with 23,102 participants, which were included in the final analysis. The intervention strategies used in these studies included short messaging services (4/14), multimode interventions (4/14), phone calls (2/14), web videos (3/14), and internet-based booking (1/14). The results indicated that electronic health interventions were more effective than control interventions for improving cervical cancer screening rates (relative risk [RR] 1.464, 95% CI 1.285-1.667; P<.001; I2=84%), cervical cancer screening (intention-to-treat) (RR 1.382, 95% CI 1.214-1.574; P<.001; I2=82%), and cervical cancer screening (per-protocol; RR 1.565, 95% CI 1.381-1.772; P<.001; I2=74%). Subgroup analysis revealed that phone calls (RR 1.82, 95% CI 1.40-2.38), multimode (RR 1.62, 95% CI 1.26-2.08), SMS (RR 1.41, 95% CI 1.14-1.73), and video- and internet-based booking (RR 1.25, 95% CI 1.03-1.51) interventions were superior to usual care. In addition, electronic health interventions did not show a statistically significant improvement in cervical cancer screening rates among women with HPV (RR 1.17, 95% CI 0.95-1.45). Electronic health interventions had a greater impact on improving cervical cancer screening rates among women in low- and middle-income areas (RR 1.51, 95% CI 1.27-1.79). There were no indications of small study effects or publication bias. Electronic health interventions are recommended in cervical cancer screening programs due to their potential to increase participation rates. However, significant heterogeneity remained in this meta-analysis. Researchers should conduct large-scale studies focusing on the cost-effectiveness of these interventions. CRD42024502884; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=502884.

Analysis of Health Promotion Strategies for Treatment of Cervical Cancer at Awal Bros Hospital Pekanbaru Riau

Cancer is one of the main causes of death, as many as 8.2 million people die from cancer. According to GLOBOCAN data in IARC (2020), cervical cancer cases in Indonesia increased by 36,633 (17.2%) with 234,511 deaths. Cervical cancer generally attacks women aged 30-39 years. Symptoms of cervical cancer are post-coital bleeding, smelly vaginal discharge, vaginal bleeding continuously without stopping, pain in the genitals are reported as early symptoms of cervical cancer. The aim of this research is to analyze Health Promotion Strategies in the treatment of cervical cancer at Awal Bros Hospital Pekanbaru. This type of research is qualitative. The number of informants was 4 informants. The results of research conducted by the health promotion program at Awal Bros Hospital in Pekanbaru show a holistic and sustainable approach in overcoming the challenge of cervical cancer. By focusing on education and empowerment, as well as addressing identified obstacles, these efforts have had a positive impact in increasing awareness, treatment compliance and quality of life for patients affected by cervical cancer. However, there is still a need to continue evaluating and adapting to increase the effectiveness of the program and ensure better access for all patients. The health promotion (advocacy) strategy for cervical cancer treatment was carried out quite well through a lobbying process and outreach to various agencies, Awal Bros Hospital carried out this by building an individual atmosphere and building a group atmosphere. By increasing participation in early screening and ensuring continuity of treatment for optimal effectiveness in preventing cervical cancer. Awal Bros Pekanbaru Hospital implements a health promotion strategy for cervical cancer with a focus on empowerment and a personal approach to patients and their families.

“You’re dealing with the bottom here…” understanding reasons for reduced utilisation: a qualitative study on colorectal cancer screening among vulnerable men at a drop-in centre in Denmark

BackgroundColorectal cancer (CRC) screening can reduce both CRC incidence and mortality, and faecal immunochemical testing (FIT)-based screening programmes are therefore now being implemented in many countries. However, social inequality in FIT-based screening participation is well documented, and initiatives to address this challenge are understudied. We explored the perceptions of CRC screening and the perceived barriers and facilitators towards FIT-based CRC screening among men visiting a drop-in centre for people with severe social problems in Denmark.MethodsThe study was a qualitative interview study. Participants were sixteen men visiting a drop-in centre in Denmark. A local staff member provided supplementary information and assisted with the recruitment process. The interviews were transcribed verbatim, followed by an inductive content analysis.ResultsThe men were often dealing with health and social problems, and they often had low self-esteem. At first, they stated that they did not think much about cancer and their own risk of being diagnosed with it. They argued that they had little time, energy, and resources to participating in, for example, CRC screening programmes, and barriers to participating were facts of life such as comorbidity and cognitive difficulties. Further, they were not sure how to participate, and some misunderstood the concept of screening. However, during the interviews, the main part of the participants became very keen to participate, and they suggested that in the future, they could receive regular information about cancer screening in face-to-face interactions with someone who cared and was interested in helping them.ConclusionMen in a vulnerable position visiting a drop-in centre were interested in CRC screening. If we intervene in a way that meets the needs among these vulnerable citizens, it may contribute to reducing social inequality in FIT-based CRC screening programmes.

Determinants of Prostate Cancer Screening in Korean Men: A Nationwide Study Using the Korean National Cancer Screening Survey 2023.

Research on the prevalence of prostate cancer (PCa) screening and reasons for undergoing screening is limited. We aimed to identify the factors influencing PCa screening behavior and explore the underlying motivations among Korean men. This cross-sectional study used data from the 2023 Korean National Cancer Screening Survey, which employs a nationally representative random sampling method. This study included 1,784 men aged 40-74 years. The respondents reported their experiences with PCa screening. Multivariable logistic regression analysis was conducted to identify the factors associated with participation in PCa screening. The lifetime PCa screening rate was 18.6%. Among screening modalities, transrectal ultrasonography was the most frequently used (31.9%), followed by prostate-specific antigen tests (25.6%) and digital rectal examinations (21.5%). The multivariable analysis identified several factors that significantly increased the likelihood of screening participation, including older age, living with a spouse, poor self-reported health, and abstinence from alcohol consumption in the previous 12 months. Men who had undergone colorectal cancer screening were more likely to participate in PCa screening (adjusted odds ratio, 4.01; 95% confidence interval, 2.03-7.93) than those who had not. The primary motivations for screening were recommendations from family or social networks (31.9%) and inclusion in health examination packages (24.3%), whereas healthcare provider recommendations (18%) and symptomatic concerns (5.7%) were the least influential. Our findings highlight the importance of providing evidence-based information for PCa screening recommendations and the need for improved communication and implementation of a shared decision-making approach for PCa screening in Korea.

Linking health-related behaviours to quality of life in older adults: A latent class analysis

Abstract Background Life expectancy and healthy life years diverge considerably in Austria, and quality of life (QoL) varies widely among older people. Identifying the factors most relevant to QoL in older people is crucial. We aimed to investigate the association between health behaviour, including lifestyle and preventive behaviour, and QoL in this population. Methods Cross-sectional data from the Austrian Health Interview Survey (2019) were used, including 3,995 individuals aged 65 years and older. We performed latent class analysis (LCA) to identify patterns of health behaviours. Variables were selected based on the WHO framework of Active Ageing including factors related to lifestyle (physical exercise, fruit/vegetable intake, BMI, oral health, smoking, alcohol use) and the health care system (satisfaction, unmet needs, participation in screening, health checks and vaccination). Domain scores of the WHOQOL-BREF were used for QoL assessment. Class differences were assessed by survey regressions. Results In the LCA, four different behavioural classes emerged among the older-aged Austrian population, including (class 1) ‘best preventive behaviour and very good lifestyle’ (17.7%), (class 2) ‘worst lifestyle and worst preventive behaviour, high unmet healthcare needs and unsatisfied with the system’ (16.5%), (class 3) ‘very good preventive behaviour and best lifestyle, but worst vaccination probability’ (24.8%) and (class 4) ‘poor preventive behaviour, good lifestyle, but no physical activity’ (41.0%). The classes with unhealthy lifestyles (classes 2 and 4) had worse QoL in all domains compared to the classes with healthy lifestyles (classes 1 and 3). The four classes differ on demographic, socio-economic and health characteristics. Conclusions To improve the QoL of the older population, policies and interventions need to be tailored to the specific characteristics and needs of each behavioural class. Key messages • This study explores the relationship between health behaviour and QoL in older Austrians. • Findings support the development of differentiated interventions targeting different types of behaviour.

Co-designed study with the Traveller Community in Ireland to determine cancer awareness &amp; attitudes

Abstract Background Irish Travellers are a distinct ethnic minority group (formal recognition March 2017). They experience higher mortality than the general population at all ages for all causes of death. Study Aim To determine cancer awareness and attitudes among the Traveller Community in Ireland, and to identify barriers/enablers to cancer risk reduction behaviours and early diagnosis of cancer. Methods A co-designed multi-method study was developed in collaboration with Pavee Point, a national NGO for Travellers, the National Social Inclusion Office (NSIO) and the National Cancer Control Programme (NCCP) including: 1. Consultation with Pavee Point and NSIO representatives to inform the study proposal and methodology. 2. Co-design of methodology for ethics applications and subsequent data collection plan including interview topic guides and the development of a culturally appropriate version of the NCCP’s 2022 National Survey on Cancer Awareness, adding questions on social determinants of health and screening participation. 3. Collaboration with 12 peer-led Primary Health Care for Travellers Projects (PHCTPs), to provide in-person training for Traveller Community Health Workers to undertake a cross-sectional survey of 380 adult Travellers. 4. Collaboration with PHCTPs to undertake 20 semi-structured interviews with Travellers. 5. Conduct of semi-structured interviews with healthcare professionals to explore perceptions of barriers/enablers for Travellers engaging with the health system. Lessons Learned Working closely and collaboratively with our study partners, we gained valuable insights which enabled effective and efficient data collection across 8 counties, while exceeding our survey target sample size. Implications for Research: Collaborative, trusting, and respectful relationships are critical for all studies, but particularly when working with minority groups. Conclusions The study findings will inform policy for improved cancer outcomes among Travellers in Ireland. Key messages • Formation of a collaborative and respectful relationship with the Traveller community has facilitated successful research. • Traveller Community Health Workers (peer researchers) were key to the success of data collection.

Lung cancer screening: Real screening site data, Vojvodina, Serbia

Abstract Background Lung cancer (LC) is the top cause of cancer-related deaths globally and in Serbia, often diagnosed in advanced stage of disease with when 5-year survival is 10% to 20%. LC screening with low-dose CT (LDCT) can decrease LC mortality and overall mortality. The first pilot LC screening program in Serbia started in the Institute for Pulmonary Diseases of Vojvodina in September 2020. The main objective of this study was to analyze LC patient characteristics according to their screening status. Methods This retrospective study utilized LC hospital registry data from September 2020 to December 2023, including gender, age at diagnosis, settlement area, smoking habits, cancer histological type, TNM classification, disease stage (1-4), and data on participation in LC screening. Group differences were assessed using chi-square and Student’s t-tests, with analyses conducted in SPSS v24.0. Results During observed period from a total of 4649 LC cases 2948 (63.4%) were males, and 73 (1.6%) were included in LC screening. Average age of all LC patients was 66 years, without differences between groups (p = 0.778). Significant differences between groups by gender were find (p = 0.042). Non-screened LC patients were significantly common males compared to females (63.6% vs 36.4%), while among screened difference by gender were lower (52.1% vs 47.9%, respectively). Screened compared to non-screened LC patients have significantly lower percentage of SCLC (9.6% vs 19.1%), and higher percentage of NSCLC (90.4% vs 80.9%), (p = 0.040). According to LC stage, screened compared to non-screened patients were significantly common diagnosed in stage I of disease (45.8% vs 7.8%), and significantly less common in higher LC stages; stage IIIB (11.1% vs 22.5%), and in stage IV (22.2% vs 45.7%), (p &amp;lt; 0.001). Conclusions LC screening with LDCT is proven secondary preventive measure with significant influence on decreasing LC mortality by increasing number of LC patients in early stages of disease. Key messages • Lung cancer screening with low-dose CT significantly increases early-stage diagnoses, improving survival chances. • Population strategies to prevent smoking and screening programs for high-risk groups are needed to reduce lung cancer incidence and mortality rates in Serbia.

Advancing mammography uptake among vulnerable groups: a systematic review of intervention strategies

Abstract With over 2 million cases diagnosed annually, breast cancer is a leading cause of cancer-related disability and mortality. Despite global efforts to implement mammography screening programs, uptake rates vary widely across settings due to socioeconomic factors and accessibility challenges. To improve participation, targeted interventions addressing barriers faced by underserved groups are essential for promoting inclusive screening and early detection. As part of the ENTER project, which aims to address disparities in breast cancer screening participation among women with low socioeconomic status (SES) in Flanders, Belgium, we conducted a systematic review and meta-analysis on the effectiveness of interventions to enhance mammography uptake. To explore the differential impact of interventions on mammography uptake among vulnerable groups, including individuals with low SES, underinsured, with immigrant background or part of an ethnic minority, subgroup analyses were performed. 7 databases were searched, resulting in the inclusion of 54 out of 9,366 papers for analysis. 14 types of interventions were identified. The meta-analysis showed significant pooled effects of interventions that increased mammography uptake [OR 1.8 (95%CI 1.6-2.2)], particularly among vulnerable populations [OR 2.2 (95%CI 1.7-2.8)]. The most effective interventions were educational interventions [OR 3.03 (95%CI 2.2-4.9); in vulnerable groups OR 2.7 (95%CI 1.9-3.9)]. As expected, interventions adapted to linguistic needs and culturally sensitive approaches showed a significant effect among vulnerable target groups [OR 2.9 (95%CI 1.1-7.9) and OR 2.5 (95%CI 1.1-5.6), respectively]. Reminders were also highly effective [OR 1.8 (95%CI 1.5-2.1); in vulnerable groups OR 2.5 (95%CI 1.9-3.1)]. This review underscores the critical role of targeted interventions in augmenting screening mammography uptake, particularly among vulnerable populations, where odds of participation can increase by up to 2-3 times. Key messages • Interventions adapted to the linguistic needs of the target population and culturally sensitive approaches, aligned with values and beliefs of a specific community, can greatly enhance screening rates. • Considering costs, practicality and impact, reminder letters with culturally and linguistically adapted content emerged as the most promising option for implementation in the ENTER project.

Decision-analytic modelling of costs &amp; benefits of adding sigmoidoscopy to CRC screening in Germany

Abstract Background In Germany, a colorectal cancer (CRC) screening programme is in place that entitles individuals to a stool test or colonoscopy. However, less than half of those eligible participate. The inclusion of an additional screening option, such as the evidence-based sigmoidoscopy, could lead to a higher overall participation rate, but also to individuals preferring the additional option to the more effective colonoscopy. The objective of this modelling study is to estimate the impact of offering sigmoidoscopy as an additional option for CRC screening in Germany. Methods A life-time mathematical model (Markov model) is developed to analyse the long-term effects of the additional offer of sigmoidoscopy on benefits (prevalence, mortality, health-related quality of life (HRQoL)), costs, and cost-effectiveness. The model is based on systematic literature reviews and real-world healthcare data. It incorporates disease development, sensitivity and specificity of the options, compliance rates, survival probabilities and background mortality. A discrete choice experiment (DCE) was conducted to estimate the future uptake of the options (stool test, colonoscopy, sigmoidoscopy, no screening) based on stated preferences of n = 666 individuals. Results Adding sigmoidoscopy leads to greater effectiveness of the CRC screening programme in terms of increased screening participation, increased adenoma detection, decreased disease-specific mortality, and improved discounted HRQoL. However, it also incurs higher costs. The incremental cost-effectiveness ratios (ICER) for men and women are €507 per quality-adjusted life year gained (QALYg) and €74 per QALYg, respectively. Conclusions The results indicate that the inclusion of sigmoidoscopy in the German CRC screening programme would be cost-effective and that sigmoidoscopy should be piloted in practice. The expanded programme has the potential to enhance the program’s effectiveness, improve health outcomes, and reduce the burden of CRC. Key messages • Expanding the CRC screening programme may increase overall participation, resulting in higher costs, but also greater effectiveness in detecting more adenomas, reducing mortality, improving HRQoL. • Introducing sigmoidoscopy in Germany appears cost-effective and justifies practical piloting to enhance CRC screening efficacy and health outcomes.

Health mediation for promoting cancer screening and vaccination in deprived neighbourhoods in France

Abstract Social inequalities in health affect access to healthcare and prevention. In Marseille, these inequalities are pronounced, with 26% of the population below the poverty line. In September 2022, a health mediation and outreach program was launched in deprived neighbourhoods to promote cancer screening and vaccination by going towards populations and providing information and orientation adapted to individuals’ health literacy and autonomy. We aimed to evaluate the effectiveness of this intervention. A repeated cross-sectional study compared knowledge, attitudes and practices about cancer screening and vaccination before and after health mediation interventions and between control and intervention neighbourhoods. Trained investigators administered a questionnaire door-to-door to individuals aged 18-74 years in randomly selected households. A first T0 survey was conducted in September 2022, and a second T1 survey is underway in May 2024, in 13 intervention and 26 control neighbourhoods. We compared the before-and-after participation rates and associated risk factors for cancer screening and vaccination between both areas using mixed regression models. Of the 2,647 respondents at T0, 61% were women, 43% non-native French speakers, 40% unemployed, and 53% had public health insurance. Survey respondents were socially deprived and had lower participation rates in cancer screening and vaccination compared to national levels. At T0, the cancer screening participation rate was 31% for colorectal cancer, 51% for breast cancer, and 68% for cervical cancer. Factors associated with non-participation were not believing in the effectiveness of cancer screening, not being aware of its existence or not speaking French. At T0, only 54% knew about human papillomavirus vaccine and only 35% of eligible women were vaccinated. A comparison of these T0 results with results of the ongoing T1 survey will be presented, in order to assess the effectiveness of this health mediation intervention. Key messages • Health mediation promotes cancer screening and vaccination by going towards populations in deprived neighbourhoods and providing information adapted to individuals’ health literacy and autonomy. • Survey respondents were socially deprived and had lower participation rates in cancer screening and vaccination compared to national levels.