Gülle Buğra Taygun, Tozduman Büşra, Ören Çelik Meryem Merve
Public Health Department, İzmir Provincial Health Directorate, İzmir, Türkiye, Turkey.
Department of Public Health, Division of Epidemiology, Faculty of Medicine, Dokuz Eylül University, İzmir, Türkiye, Turkey.
BMC Public Health. 2025 Aug 2;25(1):2637. doi: 10.1186/s12889-025-23847-1.
Cancer screening participation rates remain low globally, and understanding the factors influencing these rates is crucial for designing effective public health interventions. This study examines the demographic, socioeconomic, and lifestyle determinants of breast, cervical, and colorectal cancer screening participation in Türkiye.
This cross-sectional study utilized data from the 2022 Turkish Health Survey, a nationally representative survey conducted by the Turkish Statistical Institute. The survey employed a stratified two-stage cluster sampling method to ensure national representativeness, covering both urban and rural areas of Türkiye. The study population included 5554 women aged 40-69 years for breast cancer screening, 7277 women aged 30-65 years for cervical cancer screening, and 6541 men and women aged 50-70 years for colorectal cancer screening. Multivariate logistic regression models were used to identify factors associated with non-participation in screenings. Key variables included sociodemographic characteristics, health status, healthcare access, and lifestyle factors.
The proportions of individuals who had never undergone screening were 54.1% for colorectal, 45.9% for breast, and 51.4% for cervical cancer. Higher education and income levels were associated with increased screening participation across all cancers. Individuals with chronic diseases and those who had visited family physicians in the past year were more likely to be screened. Participation in one cancer screening significantly increased the likelihood of engaging in others. Women who had undergone cervical cancer screening had a 91% lower odds of avoiding breast cancer screening (OR: 0.09; 95% CI: 0.08-0.11). Those who participated in breast or cervical screening had 45-51% lower odds of avoiding colorectal cancer screening.
Cancer screening participation is influenced by sociodemographic factors, healthcare access, and engagement in other screenings. Findings highlight the need for targeted interventions, particularly for underserved populations, and coordinated screening strategies to improve participation and reduce disparities.
全球癌症筛查参与率仍然很低，了解影响这些比率的因素对于设计有效的公共卫生干预措施至关重要。本研究调查了土耳其乳腺癌、宫颈癌和结直肠癌筛查参与情况的人口统计学、社会经济和生活方式决定因素。
这项横断面研究使用了2022年土耳其健康调查的数据，该调查由土耳其统计研究所进行，是一项具有全国代表性的调查。该调查采用分层两阶段整群抽样方法以确保全国代表性，覆盖土耳其的城市和农村地区。研究人群包括5554名年龄在40 - 69岁的女性用于乳腺癌筛查，7277名年龄在30 - 65岁的女性用于宫颈癌筛查，以及6541名年龄在50 - 70岁的男性和女性用于结直肠癌筛查。多变量逻辑回归模型用于确定与未参与筛查相关的因素。关键变量包括社会人口统计学特征、健康状况、医疗服务可及性和生活方式因素。
从未接受过筛查的个体比例分别为：结直肠癌54.1%，乳腺癌45.9%，宫颈癌51.4%。在所有癌症中，高等教育和收入水平与筛查参与率的提高相关。患有慢性病的个体以及在过去一年中看过家庭医生的个体更有可能接受筛查。参与一种癌症筛查显著增加了参与其他筛查的可能性。接受过宫颈癌筛查的女性避免乳腺癌筛查的几率降低了91%（比值比：0.09；95%置信区间：0.08 - 0.11）。参与乳腺癌或宫颈癌筛查的个体避免结直肠癌筛查的几率降低了45 - 51%。
癌症筛查参与情况受到社会人口统计学因素、医疗服务可及性以及参与其他筛查的影响。研究结果强调了针对性干预的必要性，特别是针对服务不足人群，以及协调筛查策略以提高参与率并减少差异。
