Division of Population Health and Applied Health Sciences, Memorial University of Newfoundland, St. John's, NL, Canada.
Data and Information Services, Digital Health, NL Health Services, St. John's, NL, Canada.
Can J Public Health. 2024 Jun;115(3):371-383. doi: 10.17269/s41997-024-00859-9. Epub 2024 Mar 14.
To assess the racial and sociodemographic distribution of colorectal cancer (CRC) screening uptake in Canada, identify disparities, and evaluate the potential predictors and barriers to CRC screening.
Data from the 2017 cycle of the Canadian Community Health Survey (CCHS) were analyzed, focusing on individuals aged 50-74 years. CRC screening participation rates were evaluated at both national and provincial levels and across various sociodemographic characteristics. Multivariable logistic regression models were employed to identify predictors and barriers to CRC screening.
Of the 56,950 respondents to the 2017 CCHS, 41.7% (n = 23,727) were between 50 and 74 years of age. The overall CRC screening participation rate was 59.8%, with provinces like Alberta and Manitoba achieving rates of 65.7% and 66.5%, respectively. Significant disparities were observed across socioeconomic, geographical, and racial or ethnic groups. Notably, older adults [AOR 2.41, 95% CI 2.06‒2.83], higher income earners [AOR 1.99, 95% CI 1.77‒2.24], and non-smokers [AOR 1.76, 95% CI 1.55‒2.0] had higher odds of screening, while immigrants and minority ethnic groups, especially South-East Asians [AOR 0.48, 95% CI 0.29‒0.78] and South Asians [AOR 0.65, 95% CI 0.44‒0.95], had lower odds of being up to date with CRC screening. A significant portion of unscreened individuals cited their healthcare provider's perception of the test as unnecessary.
While there is promising progress in CRC screening participation rates across Canada, significant disparities persist. Addressing these disparities is crucial for public health. Efforts should focus on enhancing public awareness, facilitating accessibility, and ensuring cultural appropriateness of CRC screening initiatives.
评估加拿大结直肠癌（CRC）筛查的种族和社会人口分布情况，识别差异，并评估 CRC 筛查的潜在预测因素和障碍。
分析了 2017 年加拿大社区健康调查（CCHS）的数据，重点关注 50-74 岁的人群。评估了国家和省级层面以及各种社会人口特征的 CRC 筛查参与率。采用多变量逻辑回归模型来确定 CRC 筛查的预测因素和障碍。
在 2017 年 CCHS 的 56950 名受访者中，41.7%（n=23727）年龄在 50-74 岁之间。总体 CRC 筛查参与率为 59.8%，艾伯塔省和马尼托巴省的比例分别为 65.7%和 66.5%。在社会经济、地理和种族或族裔群体之间存在显著差异。值得注意的是，年龄较大的成年人（AOR 2.41，95%CI 2.06-2.83）、高收入者（AOR 1.99，95%CI 1.77-2.24）和不吸烟者（AOR 1.76，95%CI 1.55-2.0）的筛查可能性更高，而移民和少数民族群体，特别是东南亚人（AOR 0.48，95%CI 0.29-0.78）和南亚人（AOR 0.65，95%CI 0.44-0.95），则不太可能按时接受 CRC 筛查。很大一部分未接受筛查的人表示，他们的医疗保健提供者认为该测试没有必要。
尽管加拿大的 CRC 筛查参与率有了令人鼓舞的进展，但仍存在显著差异。解决这些差异对于公共卫生至关重要。应努力提高公众意识，促进可及性，并确保 CRC 筛查计划具有文化适宜性。
