Associations between cervical, breast and colorectal cancer screening uptake, chronic diseases and health-related behaviours

Data from the Italian PASSI nationwide surveillance

PASSI Working Group

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Screening programmes have been proposed as a privileged setting for health promotion interventions. We aim to assess the associations between behavioural risk factors, chronic conditions and diseases and cervical, breast and colorectal cancer screening uptake. Secondly, we aim to assess whether these associations are due to underlying differences in socioeconomic characteristics. In Italy, a random sample was interviewed by the PASSI surveillance (106,000 interviews) in 2014–2016. Screening uptake adjusted for age and gender alone and for age, gender and socioeconomic characteristics (educational attainment and self-reported economic difficulties) were estimated using multivariate Poisson regression models. Screening uptake was 79%, 73% and 45% for cervical (age 25–64), breast (women aged 50–69) and colorectal cancer (both sexes age 50–69), respectively. People with low consumption of vegetables and fruits and those with insufficient physical activity had lower uptake than people with healthy behaviours (20–22% and 8–15% lower, respectively), as did those obese and diabetic compared to healthier people (7–10% and 5–8% lower, respectively). Those with high-risk drinking behaviour, self-reported driving after drinking alcohol, and former smokers had higher screening uptake (3–7%, 3–6%, and 7–14% higher, respectively). Differences in uptake decreased after adjusting for socioeconomic characteristics, but trends were unvaried. In conclusion, screening uptake is negatively associated with unfavourable behaviours and health conditions that are also risk factors for breast and colorectal cancer incidence. Socioeconomic characteristics do not fully explain these differences. Health promotion interventions targeting diet and physical activity nested in screening programmes might miss part of the at-risk population.

Original languageEnglish
Pages (from-to)60-70
Number of pages11
JournalPreventive Medicine
Volume120
DOIs
Publication statusPublished - Mar 1 2019

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Early Detection of Cancer
Uterine Cervical Neoplasms
Colorectal Neoplasms
Chronic Disease
Breast Neoplasms
Health Promotion
Health
Exercise
Drinking Behavior
Risk-Taking
Alcohol Drinking
Vegetables
Italy
Fruit
Breast
Economics
Interviews
Diet
Incidence

Keywords

  • Behavioral risk Factor Surveillance System
  • Mass screening
  • Public health
  • Secondary prevention
  • Socioeconomic factors

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

@article{a23bea1f288b48d3844bbd02e4d831d8,
title = "Associations between cervical, breast and colorectal cancer screening uptake, chronic diseases and health-related behaviours: Data from the Italian PASSI nationwide surveillance",
abstract = "Screening programmes have been proposed as a privileged setting for health promotion interventions. We aim to assess the associations between behavioural risk factors, chronic conditions and diseases and cervical, breast and colorectal cancer screening uptake. Secondly, we aim to assess whether these associations are due to underlying differences in socioeconomic characteristics. In Italy, a random sample was interviewed by the PASSI surveillance (106,000 interviews) in 2014–2016. Screening uptake adjusted for age and gender alone and for age, gender and socioeconomic characteristics (educational attainment and self-reported economic difficulties) were estimated using multivariate Poisson regression models. Screening uptake was 79{\%}, 73{\%} and 45{\%} for cervical (age 25–64), breast (women aged 50–69) and colorectal cancer (both sexes age 50–69), respectively. People with low consumption of vegetables and fruits and those with insufficient physical activity had lower uptake than people with healthy behaviours (20–22{\%} and 8–15{\%} lower, respectively), as did those obese and diabetic compared to healthier people (7–10{\%} and 5–8{\%} lower, respectively). Those with high-risk drinking behaviour, self-reported driving after drinking alcohol, and former smokers had higher screening uptake (3–7{\%}, 3–6{\%}, and 7–14{\%} higher, respectively). Differences in uptake decreased after adjusting for socioeconomic characteristics, but trends were unvaried. In conclusion, screening uptake is negatively associated with unfavourable behaviours and health conditions that are also risk factors for breast and colorectal cancer incidence. Socioeconomic characteristics do not fully explain these differences. Health promotion interventions targeting diet and physical activity nested in screening programmes might miss part of the at-risk population.",
keywords = "Behavioral risk Factor Surveillance System, Mass screening, Public health, Secondary prevention, Socioeconomic factors",
author = "{PASSI Working Group} and Francesco Venturelli and Letizia Sampaolo and Giuliano Carrozzi and Marco Zappa and {Giorgi Rossi}, Paolo",
year = "2019",
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doi = "10.1016/j.ypmed.2019.01.007",
language = "English",
volume = "120",
pages = "60--70",
journal = "Preventive Medicine",
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T1 - Associations between cervical, breast and colorectal cancer screening uptake, chronic diseases and health-related behaviours

T2 - Data from the Italian PASSI nationwide surveillance

AU - PASSI Working Group

AU - Venturelli, Francesco

AU - Sampaolo, Letizia

AU - Carrozzi, Giuliano

AU - Zappa, Marco

AU - Giorgi Rossi, Paolo

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Screening programmes have been proposed as a privileged setting for health promotion interventions. We aim to assess the associations between behavioural risk factors, chronic conditions and diseases and cervical, breast and colorectal cancer screening uptake. Secondly, we aim to assess whether these associations are due to underlying differences in socioeconomic characteristics. In Italy, a random sample was interviewed by the PASSI surveillance (106,000 interviews) in 2014–2016. Screening uptake adjusted for age and gender alone and for age, gender and socioeconomic characteristics (educational attainment and self-reported economic difficulties) were estimated using multivariate Poisson regression models. Screening uptake was 79%, 73% and 45% for cervical (age 25–64), breast (women aged 50–69) and colorectal cancer (both sexes age 50–69), respectively. People with low consumption of vegetables and fruits and those with insufficient physical activity had lower uptake than people with healthy behaviours (20–22% and 8–15% lower, respectively), as did those obese and diabetic compared to healthier people (7–10% and 5–8% lower, respectively). Those with high-risk drinking behaviour, self-reported driving after drinking alcohol, and former smokers had higher screening uptake (3–7%, 3–6%, and 7–14% higher, respectively). Differences in uptake decreased after adjusting for socioeconomic characteristics, but trends were unvaried. In conclusion, screening uptake is negatively associated with unfavourable behaviours and health conditions that are also risk factors for breast and colorectal cancer incidence. Socioeconomic characteristics do not fully explain these differences. Health promotion interventions targeting diet and physical activity nested in screening programmes might miss part of the at-risk population.

AB - Screening programmes have been proposed as a privileged setting for health promotion interventions. We aim to assess the associations between behavioural risk factors, chronic conditions and diseases and cervical, breast and colorectal cancer screening uptake. Secondly, we aim to assess whether these associations are due to underlying differences in socioeconomic characteristics. In Italy, a random sample was interviewed by the PASSI surveillance (106,000 interviews) in 2014–2016. Screening uptake adjusted for age and gender alone and for age, gender and socioeconomic characteristics (educational attainment and self-reported economic difficulties) were estimated using multivariate Poisson regression models. Screening uptake was 79%, 73% and 45% for cervical (age 25–64), breast (women aged 50–69) and colorectal cancer (both sexes age 50–69), respectively. People with low consumption of vegetables and fruits and those with insufficient physical activity had lower uptake than people with healthy behaviours (20–22% and 8–15% lower, respectively), as did those obese and diabetic compared to healthier people (7–10% and 5–8% lower, respectively). Those with high-risk drinking behaviour, self-reported driving after drinking alcohol, and former smokers had higher screening uptake (3–7%, 3–6%, and 7–14% higher, respectively). Differences in uptake decreased after adjusting for socioeconomic characteristics, but trends were unvaried. In conclusion, screening uptake is negatively associated with unfavourable behaviours and health conditions that are also risk factors for breast and colorectal cancer incidence. Socioeconomic characteristics do not fully explain these differences. Health promotion interventions targeting diet and physical activity nested in screening programmes might miss part of the at-risk population.

KW - Behavioral risk Factor Surveillance System

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KW - Secondary prevention

KW - Socioeconomic factors

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