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International Journal of Colorectal Disease

, Volume 34, Issue 1, pp 141–150 | Cite as

The effects of reminders for colorectal cancer screening: participation and inequality

  • Ulrik DedingEmail author
  • Anna Sharon Henig
  • Christian Torp-Pedersen
  • Henrik Bøggild
Original Article

Abstract

Purpose

To investigate the effect of sending out reminders for colorectal cancer screening on socioeconomic and demographic inequalities in screening uptake.

Methods

All citizens aged 50–74 in Denmark are invited every 2 years for colorectal cancer screening. Non-participants receive an electronically distributed reminder. Data for these analyses were derived from national registers. Socioeconomic status was measured by income and educational level. Demographic variables included age, gender and marital status, and the analyses were stratified by immigration status. Logistic regression analyses were conducted to estimate the odds of non-participation for invited citizens and for reminded citizens divided by socioeconomic and demographic predictors.

Results

Of 763,511 native Danes invited for screening from 2014 to 2015, 387,116 (50.70%) participated after the initial invitation and 133,470 after receiving a reminder. Differences in participation were present in relation to all subgroups among both the invited citizens and reminded citizens. Differences persisted after full model adjustments with reductions for demographic variables. Odds ratio (OR) for non-participation in the eldest age group was 0.32 (95% CI, 0.32; 0.33) before and 1.11 (95% CI 1, 0.08; 1.14) after the reminder, compared to those under 55 years. OR for the 4th income quartile was 0.54 (95% CI, 0.53; 0.55) before and 0.44 (95% CI, 0.43; 0.45) after the reminder, compared to 1st quartile.

Conclusions

Reminders increased the overall participation, and the inequalities in participation in relation to demographic factors were reduced after the distribution of reminders. The age differences were especially reduced. The inequalities in participation related to socioeconomic status were, however, slightly increased after reminder distribution.

Keywords

Colorectal cancer screening Reminder Socioeconomic status Inequality Screening 

Notes

Compliance with ethical standards

The current study was approved by the Danish Data Protection Agency (Ref. 2008-58-0028, 2016-34). All data in the study were linked and stored in computers held by Statistics Denmark. Data were made available with de-identified personal information. This study only publishes aggregated statistical analyses and results.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Retrospective anonymized register-based studies do not require written informed consent and ethical approval [28]. This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Health Science and Technology, Public Health and Epidemiology GroupAalborg UniversityAalborg ØstDenmark
  2. 2.Unit of Epidemiology and BiostatisticsAalborg University HospitalAalborgDenmark

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