A retrospective analysis of the impact of socioeconomic deprivation on the uptake of colorectal cancer screening
Session type: Proffered paper sessions
Screening programmes based on the faecal occult blood test (FOB) have demonstrated a significant reduction in mortality for colorectal cancer (CRC). However, a significant variation exists in the uptake of the Bowel Cancer Screening Programme within the United Kingdom. Disproportionate uptake risks increasing socioeconomic inequality during staging at diagnosis and survival from CRC. This study aims to evaluate the impact of socioeconomic deprivation on the uptake of CRC screening (FOB) in an unselected population in London.
A retrospective review of the “Vanguard RM Informatics” database was performed to identify eligible individuals for CRC screening across all general practices across London over 2.5 years (2014-2017). The postcodes of the general practices were used to obtain the deprivation data such as the index of multiple deprivation rank (IMDR), income rank (IR), employment rank (ER), education and skills rank (ESR), and health and disability rank (HDR), via the “Indices of Deprivation” database. A Spearman’s rho correlation was performed to quantify the impact of the deprivation variables on FOB uptake.
Overall, 697020 individuals were eligible for screening across 1359 general practices, with a median number of eligible individuals 421 and 192 participating. From this total, 48.4%(range: 0%-74%) participated in CRC screening. The correlation results have been summarised in table 1.
Table 1- Spearman's rank correlation of deprivation indices against compliance
IMDR vs FOB Uptake
IR vs FOB Uptake
ER vs FOB Uptake
ESR vs FOB Uptake
HDR vs FOB Uptake
This is the largest study to date demonstrating a significant correlation between deprivation indices and compliance with the Bowel Cancer Screening programme. Further collaborative studies are imperative to quantify the impact of deprivation, together with specific strategies to reduce socioeconomic inequalities in CRC screening.