Socioeconomic Disparities in Participation in Organized Cancer Screening Programs

Programmatic, or organized, cancer screening refers to a systematic screening effort that is typically organized at a national level, or, as in the U.S., by a large healthcare system (e.g., Kaiser Permanente). These programs are typically based on fecal occult blood testing (FOBT). Most screening in the U.S. is opportunistic, meaning that it results from a physician–patient interaction. Although the U.S. has the world's highest screening participation rates, organized screening is generally considered a superior approach to opportunistic screening.

In this study, researchers assessed socioeconomic disparities in participation in organized colorectal screening programs. They surveyed 24 organized, FOBT-based screening programs worldwide and reviewed relevant publications. Eleven programs collected data on participation by socioeconomic status (SES), analyses of which were available in 23 publications. Lower SES was associated with lower participation in 28 of 31 unique findings published, which included SES measures of income level, economic burden of testing, quality of medical insurance, and education level. Differences in screening rates were as high as 26% between groups in the highest and lowest SES categories.