Objectives: To assess the association of the COVID-19 pandemic with an uptake rate and screening interval between two screening rounds in colorectal cancer screening program (CRCSP) and identify the disproportionate correlation of socioeconomic status (SES) factors. Methods: An analysis was performed on aggregated screening and SES data at the area level in Flanders, Belgium, during 2018–2022. The screening uptake rate was the percentage of people returning self-test results within 40 days after invitation, and the screening interval was the number of days between current and previous screening. Differences in uptake rate and screening interval before and during COVID-19 were categorized into 10 quantiles, and determinants were evaluated using quantile regression models. Results: Significant change was seen from March to August 2020. The areas with the greatest decrease in uptake rate and screening interval had low population density, and areas with the greatest increase in screening interval had the highest income and percentage of home ownership. In regression analysis, more people living alone (β = −0.09), lower income (β = 0.10), and a higher percentage of home ownership (β = −0.06) were associated with a greater decrease in uptake rate. Areas with lower population density (β = −0.75), fewer people of Belgian nationality (β = −0.11), and higher income (β = 0.42) showed greater increases in screening interval. Conclusions: During the COVID-19 pandemic, people in areas with low SES were less likely to participate in screening, whereas people in areas with high SES were more likely to delay participation. A tailored invitation highlighting benefits of CRCSP is needed for people with low SES to improve uptake. Timely warnings could help people who delay participation adhere to screening intervals.
目的：评估COVID-19大流行对结直肠癌筛查项目（CRCSP）中筛查参与率及两轮筛查间隔的影响，并识别社会经济地位（SES）因素的不均衡关联。方法：基于比利时佛兰德斯地区2018-2022年区域层面的筛查数据与社会经济数据进行整合分析。筛查参与率定义为受邀后40天内返回自检结果的人群百分比，筛查间隔为当前与既往筛查间隔天数。将COVID-19疫情前后参与率与筛查间隔的差异划分为10个分位数，采用分位数回归模型评估影响因素。结果：2020年3月至8月期间出现显著变化。参与率与筛查间隔下降最显著的区域人口密度较低，而筛查间隔延长最明显的区域具有最高收入水平及住房自有率。回归分析显示，独居人口比例较高（β=-0.09）、收入较低（β=0.10）及住房自有率较高（β=-0.06）与参与率下降幅度更大相关。人口密度较低（β=-0.75）、比利时国籍人口较少（β=-0.11）及收入较高（β=0.42）的区域筛查间隔延长更显著。结论：COVID-19大流行期间，低SES区域人群参与筛查的可能性降低，而高SES区域人群更倾向于延迟参与。需针对低SES人群设计强调CRCSP获益的个性化邀请方案以提升参与率，及时预警则有助于延迟参与者遵守筛查间隔要求。
肿瘤(癌症)患者之家