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International Journal of Public Health

, Volume 64, Issue 5, pp 813–818 | Cite as

Correction to: The education gradient in cancer screening participation: a consistent phenomenon across Europe?

  • Barbara WillemsEmail author
  • Piet Bracke
Correction
  • 487 Downloads

Correction to: Int J Public Health (2018) 63:93–103  https://doi.org/10.1007/s00038-017-1045-7

The authors would like to correct the errors in the publication of the original article. More specifically, it concerns some misclassifications of countries into organised vs. opportunistic. In the case of cervical cancer screening, Croatia had an opportunistic instead of organised screening strategy in 2006, while Denmark had an organised screening strategy instead of opportunistic screening. In the case of breast cancer screening, Germany had an organised programme instead of opportunistic screening in 2006. Lastly, with regards to colorectal cancer screening Poland had no organised programme in 2006. Due to correction of the cross-level interactions for breast and colorectal cancer screening (these changed from marginally significant to significant with the correct classification), some sentences were rephrased. Although the misclassifications did not hamper the interpretation of the results, the authors sincerely apologize for the errors. The corrected details are given below for your reading.

In the Abstract, 2nd sentence of result section should read as:

Educational inequalities in cancer screening participation were significantly smaller in countries with organised screening for cervical (OR = 0.696, 95% CI 0.531–0.912), breast (OR = 0.628, 95% CI 0.438–0.900) and colorectal (OR = 0.531, 95% CI 0.303–0.932) cancer than they were in countries with opportunistic screening.

In the Results, 1st sentence of 2nd paragraph should read as:

For cervical cancer screening, overall participation ranged from 9.4% in Romania to 69.3% in Austria, with a similar overall participation rate in countries with organised (45.1%) and opportunistic screening (49.9%) (Table 1). Overall, breast cancer screening participation varied between 8.5% in Romania to 72.1% in Austria and France, with 12.1% (51.9–39.8%) more participation in countries with organised screening strategies (Table 2). In comparison with cervical and breast cancer screening, participation in colorectal cancer screening was much lower, ranging from 2.5% in Sweden to 31.8% in Germany. In addition, only 4 of the 27 European countries had organised screening strategies for colorectal cancer (Table 3).

In the Results, 3rd sentence of 3rd paragraph should read as:

Table 4 provides the results of the multilevel logistic regressions. Educational inequalities in screening participation were significant for the three cancer types. Compared to the lowest educational group, the probability of an individual from the highest educational group participating in screening was 1.770 times higher for cervical cancer (95% CI 1.540–2.034), 1.383 times higher for breast cancer (95% CI 1.159–1.649) and 1.486 times higher for colorectal cancer (95% CI 1.212–1.822). In addition, being employed and having a partner significantly increased the probability of participating in cervical cancer screening and breast cancer screening. The cross-level interactions indicate that educational inequalities in cancer screening participation varied significantly according to a country’s screening strategy: educational inequalities were smaller in countries with organised screening strategies for cervical (OR = 0.696, 95% CI 0.531–0.912), breast (OR = 0.628, 95% CI 0.438–0.900) and colorectal (OR = 0.531, 95% CI 0.303–0.932) cancer, than they were in countries with opportunistic screening strategies.

In the Discussion, 1st sentence of 6th paragraph should read as:

With regard to the second research question (‘Do educational inequalities in cancer screening participation vary according to country-specific screening strategies?’), the results of this study clearly indicate that countries with organised cancer screening for cervical, breast and colorectal cancer allow for more equality in cancer screening participation between groups with lower and higher education than do countries with opportunistic screening.

Corrected Tables 1, 2, 3 and 4 provided here (corrected values are bold):
Table 1

Number of cases, participation rate (%) (overall and by educational level), participation rate difference (PRD = participation tertiary − participation primary) and participation rate ratio (PRR = participation tertiary/participation primary) of cervical cancer screening in the preceding 12 months in women within the appropriate age range, by country of residence and type of cancer screening strategy.

Source: Eurobarometer 66.2 (European Union 2006)

Cervical cancer screening

Screening type and country

N

Age range

Overall participation (%)

Participation by educational level

PRD (%)

PRR

Primary (%)

Secondary (%)

Tertiary (%)

Organised

3735

 

45.1

41.9

44.2

47.7

5.9

5.8

 Netherlands

304

30–60

31.6

14.8

31.2

35.3

20.5

2.39

 Denmark

258

23–59

41.9

20

25.9

44.2

24.2

2.21

 Estonia

257

30–59

29.2

30.8

31.7

25.7

− 5.1

0.83

 Finland

327

25–65

51.7

30.6

46.2

58.1

27.5

1.9

 Sweden

297

23–60

44.1

54.5

40.2

45.2

− 9.3

0.83

 UK

460

20–64

41.7

37.5

42

45.2

7.7

1.21

 Portugal

353

25–64

50.7

50.9

52.6

45.7

− 5.2

0.90

 Italy

475

25–64

52

48.2

51.7

57.8

9.6

1.20

 Slovenia

382

20–64

55.8

46.8

54.1

63.8

17

1.36

 Lithuania

258

30–60

40.7

25

36.2

47.3

22.3

1.89

 Hungary

364

25–65

46.2

28.9

52.8

58.5

29.6

2.02

Opportunistic

6230

 

49.9

37

50.9

57.7

20.7

1.56

 Austria

440

20+

69.3

64.5

72

66.1

1.6

1.02

 Germany

706

20+

54.5

40

58.2

66.7

26.7

1.67

 Luxembourg

244

15+

66

59.1

63.9

74.1

15

1.25

 France

359

20–65

61.8

48.8

62

65.1

16.3

1.33

 Belgium

358

25–64

63.7

51.9

55.3

72.4

20.5

1.39

 Latvia

487

20–70

61

53.5

58.3

68.5

15

1.28

 Ireland

343

25–60

38.2

24.5

37.7

47

22.5

1.92

 Spain

373

18–65

41.6

34.4

38.9

59.8

25.4

1.74

 Croatia

369

53.1

34.7

56.3

59.8

25.1

1.72

 Greece

487

20+

46

29.2

53.8

68.4

39.2

2.34

 Cyprus

167

30–60

49.1

46.7

52.4

44

− 2.7

0.94

 Poland

308

25–59

40.6

26.5

34.8

51.3

24.8

1.94

 Czech Republic

484

25–69

47.5

25.6

50.3

45.7

20.1

1.79

 Slovakia

502

23–64

56

25

57.6

57.6

32.6

2.30

 Romania

318

25–65

9.4

3.1

10.2

12.7

9.6

4.10

 Bulgaria

285

31–65

19.6

8.1

12.7

34.7

26.6

4.28

Europe

9965

 

48.1

38.8

48.7

53

14.2

1.37

Table 2

Number of cases, participation rate (%) (overall and by educational level), participation rate difference (PRD = participation tertiary − participation primary) and participation rate ratio (PRR = participation tertiary/participation primary) for breast cancer screening in the preceding 12 months in women within the appropriate age range, by country of residence and type of cancer screening strategy.

Source: Eurobarometer 66.2 (European Union 2006)

Breast cancer screening

Screening type and country

N

Age range

Overall participation (%)

Participation by educational level

PRD (%)

PRR

Primary (%)

Secondary (%)

Tertiary (%)

Organised

3292

 

51.9

52.2

51.8

51.7

− 0.5

0.99

 Germany

237

50–69

46.4

48.3

42.2

52.1

3.8

1.08

 Luxembourg

78

50–69

71.8

87.5

63.9

66.7

− 20.8

0.76

 France

154

50–74

72.1

76.4

65.2

78.8

2.4

1.03

 Belgium

148

50–69

66.2

60

66.2

69.8

9.8

1.16

 Netherlands

200

50–75

60.5

59.6

52.3

73.7

14.1

1.24

 Denmark

161

50–69

21.1

8.3

21.7

22.2

13.9

2.67

 Estonia

102

50–59

53.9

40

52.8

59

19

1.48

 Finland

185

50–69

54.6

61.5

57.8

48.8

− 12.7

0.79

 Sweden

277

40–74

55.2

38.5

52.4

59.3

20.8

1.54

 UK

218

50–70

40.4

39.6

42.1

37.5

− 2.1

0.95

 Portugal

229

45–69

69

69.3

72

60

− 9.3

0.87

 Spain

188

45–70

46.3

43

43.6

71.4

28.4

1.66

 Italy

152

50–69

62.5

61.4

60.3

70.8

9.4

1.15

 Croatia

171

50–69

41.5

34.8

44.9

47.2

12.4

1.36

 Cyprus

108

50–69

44.4

41.3

47.5

60

18.7

1.45

 Lithuania

197

50–69

23.4

20.6

22.1

26

5.4

1.26

 Czech Republic

281

45–69

53.4

42.1

54.1

59.6

17.5

1.42

 Hungary

206

45–65

61.7

51.3

71

57.5

6.2

1.12

Opportunistic

2035

 

39.8

29.7

43.1

44.5

14.8

1.5

 Austria

240

40–69

72.1

63.6

76.1

71.9

8.3

1.13

 Latvia

171

50–69

38

37.9

34.7

44.7

6.8

1.18

 Ireland

119

50–64

44.5

51.5

42

41.2

− 10.3

0.80

 Slovenia

200

50–69

37

29.8

39.4

40.8

11

1.37

 Greece

195

40–64

45.6

33.7

51.6

65.8

32.1

1.95

 Poland

160

50–69

39.4

24.4

40

53.3

28.9

2.18

 Slovakia

453

40+

49.7

36.4

52.9

48

11.6

1.32

 Romania

164

50–69

8.5

4

1.8

29.4

25.4

7.35

 Bulgaria

333

40+

15.9

9

13.6

26.7

17.7

2.97

Europe

5327

 

47.3

44.7

47.9

49.4

4.7

1.11

Table 3

Number of cases, participation rate (%) (overall and by educational level), participation rate difference (PRD = participation tertiary − participation primary) and participation rate ratio (PRR = participation tertiary/participation primary) for colorectal cancer screening in the preceding 12 months in men and women within the appropriate age range, by country of residence and type of cancer screening strategy.

Source: Eurobarometer 66.2 (European Union 2006)

Colorectal cancer screening

Screening type and country

N

Age range

Overall participation (%)

Participation by educational level

PRD (%)

PRR

Primary (%)

Secondary (%)

Tertiary (%)

Organised

1937

 

7.7

8.1

7.4

7.5

− 0.6

0.93

 Finland

183

60–69

11.5

19.6

12.1

5.6

− 14

0.29

 UK

575

45–74

5.6

7

5.1

3.2

− 3.8

0.46

 Italy

278

50–74

8.6

9.4

4.9

15.4

6

1.64

 Czech Republic

446

50+

9

11.9

9.2

5.6

− 6.3

0.47

Opportunistic

7706

 

10.3

9.8

10.1

11.2

1.4

1.14

 Austria

372

50+

27.2

19.7

29.3

38.8

19.1

1.97

 Germany

592

50–74

31.8

28.9

31.8

37

8.1

1.28

 Luxembourg

172

19.2

17

22.2

17

0

1

 France

317

50–74

16.1

18.6

14.3

16.3

− 2.3

0.88

 Belgium

353

50–75

10.5

13.1

9.9

9.4

− 3.7

0.72

 Netherlands

298

55–75

4.7

1.3

3.3

9.4

8.1

7.23

 Denmark

459

45–75

8.3

6.3

8.3

8.4

2.1

1.33

 Latvia

327

50–74

16.5

18

9.4

30.6

12.6

1.7

 Estonia

389

50–74

3.3

1.6

4.6

2.3

0.7

1.44

 Sweden

201

50–60

2.5

0

3.4

2.5

2.5

 Ireland

224

55–74

10.3

6.7

10.1

20

13.3

2.99

 Portugal

297

50–70

12.8

11.5

17.9

20

8.5

1.74

 Spain

215

50–69

7

5.1

7.5

22.2

17.1

4.35

 Slovenia

313

50–69

3.5

6.4

2.1

2.7

− 3.7

0.42

 Croatia

335

50–74

3.6

7

2.2

1.2

− 5.8

0.17

 Greece

455

50+

7

5.9

6.7

13.3

7.4

2.25

 Cyprus

260

50+

3.1

3.8

2.7

0

− 3.8

0

 Lithuania

384

7.3

3.2

7.5

10

6.8

3.13

 Poland

217

50–65

6.9

3.8

6.7

10

6.2

2.63

 Slovakia

491

50+

9.4

3.9

10.2

11.1

7.2

2.85

 Hungary

365

50–70

4.9

7.6

3.8

2.1

− 5.5

0.28

 Romania

353

50–74

3.1

3.7

2.1

4.2

0.5

1.14

 Bulgaria

772

31+

4.4

0.6

5.2

6

5.4

10

Europe

9643

 

9.8

9.4

9.5

10.7

1.3

1.14

Table 4

Multilevel logistic regressions using logistic odds ratios (OR > 1 = more participation) for cervical cancer screening participation (Nindividuals = 9965, Ncountry = 27), breast cancer screening participation (Nindividuals = 5327, Ncountry = 27), and colorectal cancer screening participation (Nindividuals = 9643, Ncountry = 27).

Source: Eurobarometer 66.2 (European Union 2006)

 

Cervical cancer screening

Breast cancer screening

Colorectal cancer screening

Model 1

OR (95% CI)

Model 2

OR (95% CI)

Model 1

OR (95% CI)

Model 2

OR (95% CI)

Model 1

OR (95% CI)

Model 2

OR (95% CI)

Education (primary)

      

 Secondary

1.342 (1.186–1.518)

1.454 (1.245–1.697)

1.121 (0.966–1.301)

1.412 (1.099–1.815)

1.141 (0.953–1.367)

1.214 (0.994–1.483)

 Tertiary

1.770 (1.540–2.034)

2.034 (1.702–2.431)

1.383 (1.159–1.649)

1.883 (1.398–2.537)

1.486 (1.212–1.822)

1.649 (1.319–2.062)

Age

0.988 (0.984–0.992)

0.988 (0.984–0.992)

0.979 (0.970–0.989)

0.980 (0.971–0.990)

1.005 (0.993–1.017)

1.005 (0.993–1.017)

Work status (employed)

      

 Unemployed

0.829 (0.702–0.980)

0.829 (0.702–0.980)

0.457 (0.338–0.620)

0.459 (0.338–0.623)

0.944 (0.639–1.394)

0.942 (0.638–1.391)

 Non-employed

0.796 (0.719–0.882)

0.797 (0.720–0.882)

0.815 (0.703–0.944)

0.811 (0.700–0.939)

1.077 (0.889–1.305)

1.081 (0.892–1.310)

Partner (no partner)

1.395 (1.272–1.530)

1.394 (1.271–1.528)

1.358 (1.198–1.539)

1.354 (1.194–1.535)

1.006 (0.862–1.174)

1.008 (0.863–1.177)

Good self-reported health (bad)

1.049 (0.949–1.159)

1.050 (0.950–1.161)

0.883 (0.775–1.007)

0.881 (0.772–1.004)

0.729 (0.624–0.851)

0.732 (0.627–0.855)

Organised screening (opportunistic)

0.796 (0.480–1.320)

1.003 (0.585–1.719)

1.944 (1.080–3.501)

2.555 (1.375–4.746)

1.012 (0.480–2.136)

1.324 (0.599–2.929)

Female (male)

    

0.914 (0.789–1.059)

0.914 (0.789–1.059)

Organised screening × secondary education

 

0.804 (0.629–1.027)

 

0.707 (0.521–0.960)

 

0.723 (0.458–1.142)

Organised screening × tertiary education

 

0.696 (0.531–0.912)

 

0.628 (0.438–0.900)

 

0.531 (0.303–0.932)

Country variance (SE)

0.421 (0.118)

0.426 (0.119)

0.513 (0.147)

0.504 (0.144)

0.541 (0.162)

0.550 (0.164)

Correction to the references

Kaminski MF, Kraszewska E, Rupinski M, Laskowska M, Wieszczy P, Regula J (2015) Design of the Polish Colonoscopy Screening Program: a randomized health services study. Endoscopy 47(12):1144–1150

Lynge E, Andersen B, Christensen J, Ejersbo D, Jochumsen K, Johansen T et al (2017) Cervical screening in Denmark—a success followed by stagnation. Acta Oncol 1–8

Malek D, Kääb-Sanyal V (2016) Implementation of the German Mammography Screening Program (German MSP) and first results for initial examinations, 2005–2009. Breast Care 11(3):183–187

Petry KU, Menton S, Menton M, van Loenen-Frosch F, de Carvalho Gomes H, Holz B et al (2003) Inclusion of HPV testing in routine cervical cancer screening for women above 29 years in Germany: results for 8466 patients. Br J Cancer 88:1570.  https://doi.org/10.1038/sj.bjc.6600918

Vrdoljak-Mozetič D, Verša Ostojić D, Štemberger-Papić S, Janković S, Glibotić-Kresina H, Brnčić-Fischer A, Benić-Salamon K (2010) Cervical Cancer Screening Programme in Primorsko-Goranska County, Croatia—the results of the pilot study. Coll Antropol 34(1):225–232

Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  1. 1.Ghent UniversityGhentBelgium

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