Objective Colorectal cancer (CRC) screening programmes can reduce CRC mortality. However, the implementation of a screening programme may create or exacerbate socioeconomic and ethnic health inequities if participation varies by subgroup. We determined which organised programmes characterise participation inequities by socioeconomic and ethnic subgroups, and assessed the variation in subgroup participation among programmes collecting group-specific data. Design Employing a literature review and survey among leaders of national or regional screening programmes, this study identified published and unpublished data on participation by socioeconomic status and ethnicity. We assessed programmes offering faecal occult blood tests (FOBT) for screening. Primary outcome was screening participation rate. Results Across 24 organised FOBT-screening programmes meeting the inclusion criteria, participation rates ranged from 21% to 73%. Most programmes (13/24, 54%) did not collect data on participation by socioeconomic status and ethnicity. Among the 11 programmes with data on participation by socioeconomic status, 90% (28/31 publications) reported lower participation among lower socioeconomic groups. Differences across socioeconomic gradients were moderate (66% vs 71%) to severe (35% vs 61%). Only six programmes reported participation results by ethnicity. Ethnic differences were moderate, though only limited data were available for evaluation. Conclusions Across organised CRC screening programmes worldwide, variation in participation by socioeconomic status and ethnicity is often not assessed. However, when measured, marked disparities in participation by socioeconomic status have been observed. Limited data were available to assess inequities by ethnicity. To avoid exacerbating health inequities, screening programmes should systematically monitor participation by socioeconomic status and ethnicity, and investigate and address determinants of low participation.

中文翻译：

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全球有组织的结直肠癌筛查计划中的社会经济和种族不平等

目的 结直肠癌 (CRC) 筛查计划可以降低 CRC 死亡率。然而，如果参与因亚组而异，筛查计划的实施可能会造成或加剧社会经济和种族健康不平等。我们确定了哪些有组织的项目体现了社会经济和种族亚群的参与不平等，并评估了收集特定群体数据的项目之间亚群参与的差异。设计 本研究对国家或地区筛选项目的负责人进行了文献回顾和调查，确定了有关社会经济地位和种族参与的已发表和未发表数据。我们评估了提供粪便潜血试验 (FOBT) 进行筛查的项目。主要结果是筛查参与率。结果 在符合纳入标准的 24 个有组织的 FOBT 筛查计划中，参与率从 21% 到 73% 不等。大多数项目（13/24，54%）没有收集关于社会经济地位和种族参与的数据。在按社会经济地位提供参与数据的 11 个项目中，90%（28/31 出版物）报告较低社会经济群体的参与度较低。社会经济梯度的差异从中度（66% 对 71%）到严重（35% 对 61%）。只有六个项目按种族报告了参与结果。种族差异中等，但可用于评估的数据有限。结论 在全世界有组织的 CRC 筛查项目中，通常没有评估因社会经济地位和种族而导致的参与差异。然而，当测量时，社会经济地位在参与方面存在显着差异。可用于评估种族不平等的数据有限。为避免加剧健康不平等，筛查计划应系统地监测社会经济地位和种族的参与情况，并调查和解决低参与率的决定因素。