Participation and retention in the breast cancer screening program in New Brunswick Canada

McDonald, James Ted; Wang, Yunli; Liu, Zikuan

doi:10.1016/j.pmedr.2017.03.015

Cited by 5 publications

(4 citation statements)

References 21 publications

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“…Populations with low spatial access are less likely to participate in screening services. In Canada, increased travel time has consistently been associated with lower participation in existing screening services [ 16 , 17 ] and radiotherapy (RT) utilization [ 18 , 29 , 32 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the US, studies suggest that while most of the screen-eligible population are within close proximity to a screening site, a small proportion has poor spatial access [ 13 , 14 , 15 ]. In Canada, increasing travel time and level of urbanization was associated with lower screening rates in breast mammography screening [ 16 , 17 ], and colorectal cancer screening [ 18 , 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Addressing Inequity in Spatial Access to Lung Cancer Screening

Simkin,

Khoo,

Darvishian

et al. 2023

Current Oncology

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Background: The successful implementation of an equitable lung cancer screening program requires consideration of factors that influence accessibility to screening services. Methods: Using lung cancer cases in British Columbia (BC), Canada, as a proxy for a screen-eligible population, spatial access to 36 screening sites was examined using geospatial mapping and vehicle travel time from residential postal code at diagnosis to the nearest site. The impact of urbanization and Statistics Canada’s Canadian Index of Multiple Deprivation were examined. Results: Median travel time to the nearest screening site was 11.7 min (interquartile range 6.2–23.2 min). Urbanization was significantly associated with shorter drive time (p < 0.001). Ninety-nine percent of patients with ≥60 min drive times lived in rural areas. Drive times were associated with sex, ethnocultural composition, situational vulnerability, economic dependency, and residential instability. For example, the percentage of cases with drive times ≥60 min among the least deprived situational vulnerability group was 4.7% versus 44.4% in the most deprived group. Conclusions: Populations at risk in rural and remote regions may face more challenges accessing screening services due to increased travel times. Drive times increased with increasing sociodemographic and economic deprivations highlighting groups that may require support to ensure equitable access to lung cancer screening.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Addressing Inequity in Spatial Access to Lung Cancer Screening

Simkin,

Khoo,

Darvishian

et al. 2023

Current Oncology

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“…In practice, health screening programs may entail multiple follow-ups of several cohorts with different intervals over an extended period of time because of resource and logistic constraints. Compared to the participation in health screening, little is known about the retention of participants over time [ 18 ], which would be important in estimating and interpreting the performance and impact of community-based interventions.…”

Section: Introductionmentioning

confidence: 99%

Retention in Community Health Screening among Taiwanese Adults: A 9-Year Prospective Cohort Study

Chang

Kang

et al. 2022

IJERPH

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Largely conducted in Western developed nations, research on community health screening has mainly been of limited duration. This study aims to ascertain the predictors of retention in a community health screening program, involving multiple admission cohorts over a 9-year period in Taiwan. Retention is defined as the participation in subsequent waves of health screening after being recruited for an initial screening. Data came from a prospective cohort study, named “Landseed Integrated Outreaching Neighborhood Screening (LIONS)”, in Taiwan. This research retrieved 5901 community-dwelling Taiwanese adults aged 30 and over from LIONS and examined their retention in three follow-ups during 2006–2014. Generalized estimating equations were employed to evaluate retention over time as a function of social determinants, health behaviors, and health conditions. Being middle-aged, higher education, and regular exercise were positively associated with retention. Conversely, smoking, betel-nut chewing, psychiatric disorder, hypertension, type 2 diabetes mellitus, stroke, and a longer time interval since enrollment were negatively associated with retention. Furthermore, retention rates varied substantially across admission cohorts with more recent cohorts having a lower rate of retention (aOR = 0.33–0.83). Greater attention needs to be directed to retention over time and variations across admission cohorts. Additionally, those who are in either younger or older age groups and have chronic diseases or unhealthy behaviors should be targeted with greater efforts.

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“…Women living in rural areas or far away from mammography centers participate less in breast cancer screening. [23][24][25][26][27][28] In France, women living in rural areas and those living more than 15 minutes away from a screening center are, respectively, 13% and 9% less likely to participate compared with women living in urban areas or less than 15 minutes from a screening center. 29 Breast cancer screening can be delivered by mobile mammography units (MMUs), which were first introduced to increase geographical access but also to reach deprived women.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness Analysis of a Mobile Mammography Unit for Breast Cancer Screening to Reduce Geographic and Social Health Inequalities

et al. 2019

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Background: Breast cancer is the leading cancer in terms of incidence and mortality among women in France. Effective organized screening does exist, however, the participation rate is low, and negatively associated with a low socioeconomic status and remoteness.Objectives: To determine the cost-effectiveness of a mobile mammography (MM) program to increase participation in breast cancer screening and reduce geographic and social inequalities.Methods: A cost-effectiveness analysis from retrospective data was conducted from the payer perspective, comparing an invitation to a mobile mammography unit (MMU) or to a radiologist's office (MM or RO group) with an invitation to a radiologist's office only (RO group) (n = 37461). Medical and nonmedical direct costs were estimated. Outcome was screening participation. The mean incremental cost and effect, the incremental cost-effectiveness ratio, and the costeffectiveness acceptability curve were estimated.Results: The mean incremental cost for invitation to MM or RO was estimated to be V23.21 (95% CI, 22.64-23.78) compared with RO only, and with a point of participation gain of 3.8% (95% CI, 2.8-4.8), resulting in an incremental cost per additional screen of V610.69 (95% CI, 492.11-821.01). The gain of participation was more important in women living in deprived areas and for distances exceeding 15 km from an RO. Conclusion:Screening involving a MMU can increase participation in breast cancer screening and reduce geographic and social inequalities while being more cost-effective in remote areas and in deprived areas. Because of the retrospective design, further research is needed to provide more evidence of the effectiveness and cost-effectiveness of using a MMU for organized breast cancer screening and to determine the optimal conditions for implementing it.

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Participation and retention in the breast cancer screening program in New Brunswick Canada

Cited by 5 publications

References 21 publications

Addressing Inequity in Spatial Access to Lung Cancer Screening

Addressing Inequity in Spatial Access to Lung Cancer Screening

Retention in Community Health Screening among Taiwanese Adults: A 9-Year Prospective Cohort Study

Cost-Effectiveness Analysis of a Mobile Mammography Unit for Breast Cancer Screening to Reduce Geographic and Social Health Inequalities

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