Van den Bergh Simon, Casas Lidia, Ertaylan Gökhan, Van Hal Guido, Bessems Jos
Environmental Intelligence Unit, Flemish Institute for Technological Research (VITO), Industriezone Vlasmeer 5, 2400, Mol (BE), Belgium.
Department of Family Medicine and Population Health (FAMPOP), Social Epidemiology and Health Policy (SEHPO), University of Antwerp, Universiteitsplein 1, 2610, Wilrijk (BE), Belgium.
Arch Public Health. 2025 Mar 25;83(1):79. doi: 10.1186/s13690-025-01541-3.
Despite its potential with regard to the prevention and early detection of colorectal cancer (CRC), participation in the organized CRC screening programme of the Belgian region of Flanders is suboptimal. The role of language discordance as a determinant of screening participation in Europe is poorly understood, despite being identified as a potential barrier in qualitative and non-European studies.
In an ecological study analysing data on the level of Flemish municipalities (n = 300) from 2016 to 2021, we investigated whether the proportion of non-Dutch speakers at home is correlated with the response rate to CRC screening programme invitations and/or the total CRC screening coverage using multiple linear regression. We also performed Kruskal-Wallis tests and Dunn's tests to examine municipal differences in screening based on their adjacency to the regions of Brussels and Wallonia.
After adjusting for confounders, the proportion of secondary school pupils that primarily speak a language other than Dutch at home was associated with a lower screening response rate (β = -0.327, 95% CI -0.359; -0.296)) and lower total screening coverage (β = -0.195, 95% CI -0.219; -0.171). Response rates and coverage were higher in municipalities at least two municipalities away from the border with Wallonia, Brussels or France. Our findings suggest that a high proportion of French speakers is particularly indicative of linguistic barriers to screening in Flemish municipalities (β = -0.358, 95% CI -0.397; -0.319 for response rate and β = -0.213, 95% CI -0.238; -0.188 for total coverage).
Our study highlights the need to consider potential linguistic challenges when optimizing CRC screening policies.
尽管在预防和早期发现结直肠癌（CRC）方面具有潜力，但参与比利时弗拉芒地区有组织的CRC筛查计划的情况并不理想。尽管在定性研究和非欧洲研究中语言不一致被确定为潜在障碍，但在欧洲作为筛查参与决定因素的作用却知之甚少。
在一项生态研究中，分析了2016年至2021年弗拉芒各市镇（n = 300）的数据，我们使用多元线性回归研究了家中非荷兰语使用者的比例是否与CRC筛查计划邀请的响应率和/或总CRC筛查覆盖率相关。我们还进行了Kruskal-Wallis检验和Dunn检验，以检查根据各市镇与布鲁塞尔和瓦隆地区的相邻程度在筛查方面的差异。
在调整混杂因素后，在家中主要说荷兰语以外语言的中学生比例与较低的筛查响应率（β = -0.327，95% CI -0.359；-0.296）和较低的总筛查覆盖率（β = -0.195，95% CI -0.219；-0.171）相关。与瓦隆、布鲁塞尔或法国接壤至少两个市镇以内的市镇的响应率和覆盖率较高。我们的研究结果表明，法语使用者比例高尤其表明弗拉芒市镇在筛查方面存在语言障碍（响应率β = -0.358，95% CI -0.397；-0.319，总覆盖率β = -0.213，95% CI -0.238；-0.188）。
我们的研究强调了在优化CRC筛查政策时考虑潜在语言挑战的必要性。
