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Sun J, Zhu Y, Huang D, Li L, Pan M, Li F, Ma C. Burden of female diseases among adolescents and young adults aged 10-24 years in South Asia and Sub-Saharan Africa, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021. J Adv Res 2025:S2090-1232(25)00371-6. [PMID: 40425083 DOI: 10.1016/j.jare.2025.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 04/28/2025] [Accepted: 05/23/2025] [Indexed: 05/29/2025] Open
Abstract
INTRODUCTION Female diseases pose significant challenges in South Asia and Sub-Saharan Africa, particularly among adolescent girls and young women, who often receive insufficient attention. OBJECTIVES To report patterns and trends of female diseases among adolescent girls and young females aged 10-24 years in South Asia and Sub-Saharan Africa from 1990 to 2021. METHODS We used data from the Global Burden of Disease Study 2021 for 51 countries in South Asia and Sub-Saharan Africa between 1990 and 2021. Joinpoint Regression was used to calculate annual average percentage changes and 95 % confidence intervals to quantify temporal trends. RESULTS In 2021, South Asia and Sub-Saharan Africa had high mortality rates of maternal disorders of 6.04 (95 % uncertainty intervals 5.02, 7.39) and 17.69 (14.37, 21.78) per 100,000 population, respectively. The mortality rates for female cancers were approximately 0.98 in both regions, and the incidence rates for gynecological diseases were 16472.83 and 14480.99, per 100,000 population, respectively. From 1990 to 2021, there was an increasing trend in the number of maternal disorder deaths in Sub-Saharan Africa, as well as in all metric rates for most female cancers in both regions, and disability-adjusted life years, prevalence, and incidence rates for gynecological diseases in South Asia. Several female diseases varied across countries and were increasingly affecting younger adolescents aged 10-14 years in both regions. Although countries with lower Socio-demographic Index had a heavier burden of female diseases, no significant association was observed between the Universal Health Coverage effective coverage index and death rates for female cancers or gynecological diseases. CONCLUSIONS The burden of female diseases remains high among young females in South Asia and Sub-Saharan Africa, with younger adolescents being particularly affected. This underscores the urgent need for targeted interventions and increased investment in healthcare infrastructure to reduce the burden of female diseases in these regions.
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Affiliation(s)
- Jiahong Sun
- Department of Preventive Medicine, School of Public Health, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808 Guangdong, China
| | - Yongliang Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Danyi Huang
- Department of Epidemiology and Health Statistics, School of Public Health, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Liuqing Li
- Department of Preventive Medicine, School of Public Health, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan 523808 Guangdong, China
| | - Mengna Pan
- Department of Epidemiology and Health Statistics, School of Public Health, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Fei Li
- Department of Childcare and Wellness, the First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong 523710, China
| | - Chuanwei Ma
- Department of Epidemiology and Health Statistics, School of Public Health, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong 523808, China.
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Hultstrand C, Brynskog E, Karlsson Rosenblad A, Sunesson AL, Björk-Eriksson T, Sharp L. Low levels of awareness and motivation towards cancer prevention amongst the general public in Sweden: a cross-sectional study focusing on the European Code Against Cancer. BMC Public Health 2025; 25:1692. [PMID: 40336012 PMCID: PMC12057043 DOI: 10.1186/s12889-025-22803-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2024] [Accepted: 04/15/2025] [Indexed: 05/09/2025] Open
Abstract
BACKGROUND The European Code Against Cancer (ECAC) aims to increase the awareness of modifiable cancer risk factors among the general public. A goal set by the European Commission was that 80% of European citizens should be aware of this code by 2025. This study aims to examine the awareness and attitudes towards the ECAC among the general public in Sweden. METHODS A randomly selected sample of 1520 Swedes (18-84 years old) were recruited from a survey panel and invited to respond to an online study-specific questionnaire. The questionnaire included general questions regarding cancer prevention, as well as awareness and attitudes specific to the ECAC. Data were analysed univariately and with adjusted logistic regression, using post-stratification weights based on gender, age, education, and expressed political party orientation. RESULTS In total, 3.7% of the respondents had heard about the ECAC before taking this survey. Respondents with a college/university education were more likely to have heard about the ECAC (odds ratio [OR] 2.23; 95% confidence interval [CI] 1.23-4.06). Males (OR 0.56; 95% CI 0.32-0.99), and those living alone (OR 0.47; 95% CI 0.23-0.95) were less likely to have heard about the ECAC. In total, 60.6% of the respondents agreed with the ECAC recommendations, while 27.4% reported that their motivation to improve their lifestyle increased after reading the ECAC. CONCLUSIONS Awareness of the ECAC among the general public in Sweden is very low. Still, a majority seem to agree with its recommendations. The results also indicate that the ECAC motivates some, but far from all, to improve their lifestyle habits to reduce their cancer risk. Consequently, further research is warranted on how the ECAC best could and should be used in order to improve cancer prevention awareness and motivation.
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Affiliation(s)
- Cecilia Hultstrand
- Regional Cancer Centre North. Norrlands universitetssjukhus, Umeå, 901 85, Sweden
- Department of nursing, Umeå University, Umeå, 901 87, Sweden
| | - Ellen Brynskog
- Regional Cancer Centre West. Medicinaregatan 18G, Gothenburg, 413 90, Sweden.
- Department of health sciences, Karlstad University, Karlstad, 651 88, Sweden.
| | - Andreas Karlsson Rosenblad
- Regional Cancer Centre Stockholm-Gotland, Lindhagensgatan 98, Stockholm, 112 18, Sweden
- Department of Statistics, Uppsala University, Uppsala, Sweden
| | - Anna-Lena Sunesson
- Regional Cancer Centre North. Norrlands universitetssjukhus, Umeå, 901 85, Sweden
- Department of Diagnostics and Intervention, Umeå University, Umeå, 901 87, Sweden
| | - Thomas Björk-Eriksson
- Regional Cancer Centre West. Medicinaregatan 18G, Gothenburg, 413 90, Sweden
- Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lena Sharp
- Department of nursing, Umeå University, Umeå, 901 87, Sweden
- Regional Cancer Centre Stockholm-Gotland, Lindhagensgatan 98, Stockholm, 112 18, Sweden
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Oldhoff-Nuijsink C, Derksen ME, Engelsma T, Peute LWP, Fransen MP. Digital tools to support informed decision making among screening invitees in a vulnerable position for population-based cancer screening: A scoping review. Int J Med Inform 2024; 192:105625. [PMID: 39317034 DOI: 10.1016/j.ijmedinf.2024.105625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 08/21/2024] [Accepted: 09/06/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND Individuals in a vulnerable position are generally less inclined to participate in population-based cancer screening. Digital tools, such as educational videos, narratives or decision aids, show promise in reaching and informing these invitees by tailoring information needs based on their preferences. This review aims to provide an overview of design features and reported outcomes of digital tools intended to support informed decision making among screening invitees in a vulnerable position. METHODS The review was conducted according to the Preferred Reporting Items for Scoping Reviews guidelines. We searched PubMed, Scopus/MEDLINE and Web of Science and included studies when the effectiveness of the digital tool was assessed and focussed on reaching and/or informing screening invitees in a vulnerable position for breast, cervical or colorectal cancer screening. For each included study, the study population, type of digital tool, the development process, reported design features and reported effects were extracted. FINDINGS We found 448 articles, and finally 13 were included in this review after reading full text. Study designs included randomised controlled trials (n = 5), pre-post-test design (n = 7) and experimental design (n = 1). Six different types of digital tools were identified: decision aids (n = 6), educational programs (n = 3), narrative video (n = 1), text-messaging intervention (n = 1), animation video (n = 1), and iPad program (n = 1). A population specific design was applied in 12/13 interventions, such as avoiding jargon and using a voice over function. Reported outcomes measures regarding reaching and informing the target population were: knowledge, attitude, screening intention, self-efficacy, susceptibility, feeling informed, values clarity, and screening uptake. All digital tools reported a significant improvement on at least one of the reported outcome measures. PRINCIPAL CONCLUSIONS The use of digital tools seems to contribute to reach or inform screening invitees in a vulnerable position for cancer screening. However, insufficient evidence was found regarding the development process of the tools and their effects on outcome measures related to reaching and informing the screening invitees in a vulnerable position. Future research may look in to combining multiple digital tools and animated visual information in combination with spoken text to improve reaching and informing screening invitees in a vulnerable position.
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Affiliation(s)
- Corine Oldhoff-Nuijsink
- Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, eHealth Living & Learning Lab Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands; Amsterdam Public Health, Societal Participation & Health, Amsterdam, the Netherlands.
| | - Marloes E Derksen
- Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, eHealth Living & Learning Lab Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Thomas Engelsma
- Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, eHealth Living & Learning Lab Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Linda W P Peute
- Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, eHealth Living & Learning Lab Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Mirjam P Fransen
- Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands; Amsterdam UMC, location University of Amsterdam, Department of Public and Occupational Health, de Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands; National Institute for Public Health and the Environment, Centre for Prevention, Lifestyle and Health, Department of Behaviour and Health, Antonie van Leeuwenhoeklaan 9, Bilthoven, the Netherlands
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Marandu G, Malale K, Laisser R, Mwanga J, Sabuni PA, Rambau P. Evaluation of Breast Health Promotion Intervention Among Catholic Nuns in Lake Zone 'Tanzania. Eur J Breast Health 2024; 20:129-135. [PMID: 38571689 PMCID: PMC10985581 DOI: 10.4274/ejbh.galenos.2024.2024-1-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/27/2024] [Indexed: 04/05/2024]
Abstract
Objective Despite facing unique barriers, Catholic nuns in Tanzania require accessible breast health promotion. This study explores interventions to empower nuns through knowledge, improved attitudes, and positive practices, ultimately promoting well-being and early detection for better breast cancer outcomes. Materials and Methods A quasi-experimental design study guided by the Health Belief Model was conducted to monitor the implementation of a breast health intervention program aimed at increasing breast cancer screening knowledge among 385 Catholic nuns aged 20 to over 60 years old within Lake Zone, Tanzania. Data were collected at two-time points: pre-intervention (baseline) and implementation phase intervention (after three months). The intervention consisted of a 2-hour educational session. Participants had opportunities to ask questions and provide feedback. Results The breast health promotion intervention was well-received by Catholic nuns, with 339 (88%) expressing strong motivation to learn and promote awareness. The training effectively increased knowledge and positive attitudes towards breast cancer screening. Researcher assistants successfully delivered the program, and 354 (92%) of participants expressed interest in continued education and support. The intervention addressed cultural barriers and empowered nuns to take charge of their health, though some challenges remain meanwhile 158 (41%) had limited prior knowledge, 81 (21%) hesitated to discuss breast health due to religious beliefs, and some faced difficulty applying the learnings. Conclusion Overall, the breast health promotion intervention had a positive outcome on the Catholic nuns' awareness and knowledge of breast health. However, addressing the identified barriers and challenges is crucial to further enhance the intervention's effectiveness and sustainability.
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Affiliation(s)
- Gotfrida Marandu
- Archbishop Anthony Mayala School of Nursing, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Kija Malale
- Archbishop Anthony Mayala School of Nursing, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Rose Laisser
- Archbishop Anthony Mayala School of Nursing, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Joseph Mwanga
- Department of Community Medicine, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Paul Alikado Sabuni
- Public Health Consultant, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Peter Rambau
- Department of Pathology, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
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Karlsson Rosenblad A, Westman B, Bergkvist K, Segersvärd R, Roos N, Bergenmar M, Sharp L. Differences in health-related quality of life between native and foreign-born gynaecological cancer patients in Sweden: a five-year cross-sectional study. Qual Life Res 2024; 33:667-678. [PMID: 37930556 PMCID: PMC10894133 DOI: 10.1007/s11136-023-03548-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE To examine differences in health-related quality of life (HRQoL) between native and foreign-born gynaecological cancer patients in Sweden, taking into account clinical, demographic, and socioeconomic factors. METHODS The 30-item European Organisation for Research and Treatment of Cancer quality of life questionnaire (QLQ-C30) and a study-specific questionnaire covering demographic and socioeconomic factors were answered by 684 women aged ≥ 18 years old, diagnosed in 2014, 2016, or 2018 with gynaecological cancer in the Stockholm-Gotland health care region, Sweden. Clinical data were obtained from the Swedish Cancer Register. Data were analysed using the Kruskal-Wallis test and linear regression. RESULTS The women had a mean age of 65.4 years, with 555 (81.1%) born in Sweden, 54 (7.9%) in other Nordic countries (ONC), 43 (6.3%) in other European countries (OEC), and 32 (4.7%) in non-European countries (NEC). HRQoL differed significantly between the four groups for 14 of the 15 QLQ-C30 scales/items. On average, Swedish-born women scored 2.0, 15.2, and 16.7 points higher for QoL/functioning scales/items and 2.2, 14.1, and 18.7 points lower for symptom scales/items, compared with ONC-, OEC-, and NEC-born women, respectively. In adjusted analyses, none of the differences between Swedish-born and ONC-born women were significant, while for OEC- and NEC-born women the differences were significant for most QLQ-C30 scales/items. CONCLUSION HRQoL differs between native and foreign-born gynaecological cancer patients in Sweden, with lower HRQoL the further from Sweden the women are born. A more individualised cancer care, with tailored support to optimize HRQoL is needed for this vulnerable group of patients.
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Affiliation(s)
- Andreas Karlsson Rosenblad
- Regional Cancer Centre Stockholm-Gotland, Box 6909, SE-102 39, Stockholm, Sweden.
- Division of Clinical Diabetology and Metabolism, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Department of Statistics, Uppsala University, Uppsala, Sweden.
| | - Bodil Westman
- Regional Cancer Centre Stockholm-Gotland, Box 6909, SE-102 39, Stockholm, Sweden
- Department of Care Science, Sophiahemmet University, Stockholm, Sweden
| | - Karin Bergkvist
- Department of Care Science, Sophiahemmet University, Stockholm, Sweden
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Segersvärd
- Regional Cancer Centre Stockholm-Gotland, Box 6909, SE-102 39, Stockholm, Sweden
- Department of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Nathalie Roos
- Regional Cancer Centre Stockholm-Gotland, Box 6909, SE-102 39, Stockholm, Sweden
- Division of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mia Bergenmar
- Department of Care Science, Sophiahemmet University, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lena Sharp
- Regional Cancer Centre Stockholm-Gotland, Box 6909, SE-102 39, Stockholm, Sweden
- Department of Nursing, Umeå University, Umeå, Sweden
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Efremius S, Eriksson LE, Kleijberg M. Investigating Peer Advisors’ Strategies to Promote Cancer Prevention and Early Detection in Swedish Communities with Challenging Socioeconomic Conditions. HEALTH & SOCIAL CARE IN THE COMMUNITY 2023; 2023:1-13. [DOI: 10.1155/2023/6692655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
Abstract
Worse socioeconomic conditions (e.g., having a migration background, lower income, and lower educational level) may lead to barriers for cancer prevention and early detection. Community-based initiatives providing tailored and accessible information are found to increase cancer screening participation and improve health outcomes for people with challenging socioeconomic conditions. To inform such initiatives, more research is needed from the perspective of those working with them. This article focuses on the Swedish “peer advisor project” in which the Regional Cancer Centre Stockholm Gotland (RCC) collaborates with community-based peer advisors to reduce cancer inequities in areas with challenging socioeconomic conditions. We aim to investigate the perspectives of people working with the peer advisor project in relation to challenges they face, strategies they use, and forms of impact they perceive their work to have. We used a participatory action research approach, involving 12 peer advisor representatives and three RCC representatives. Underlying data (interviews and participant observations) were qualitatively analyzed. Findings are presented in relation to three themes: (1) Peer advisors bridge a gap between the cancer care system and communities through dialogues with communities and RCC representatives. (2) Peer advisors navigate culturally based sensitivities through efforts to create safe spaces for discussing cancer prevention and early detection. (3) Peer advisor and RCC representatives described forms of impact in relation to personal contexts, community contexts, RCC’s organizational context, and societal context. Sustainability and structural challenges may limit the peer advisor project to create impact. We discuss that peer advisors may act as cultural brokers through dialogues with communities and the cancer care system, thereby increasing an understanding of communities’ contexts and needs. Findings from this study can inform development and implementation of similar community-based peer-to-peer initiatives in other contexts. More research is needed to investigate the long-term impact of the project including community-based perspectives.
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Affiliation(s)
- Simon Efremius
- Regional Cancer Centre, Stockholm-Gotland, SE-10425 Stockholm, Sweden
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, 23300, SE-141 83 Huddinge, Sweden
| | - Lars E. Eriksson
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, 23300, SE-141 83 Huddinge, Sweden
- City, University of London, School of Health and Psychological Sciences, EC1V 0HB, London, UK
- Karolinska University Hospital, Medical Unit Infectious Diseases, SE-141 86 Huddinge, Sweden
| | - Max Kleijberg
- Regional Cancer Centre, Stockholm-Gotland, SE-10425 Stockholm, Sweden
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, 23300, SE-141 83 Huddinge, Sweden
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Sharp L, Dodlek N, Willis D, Leppänen A, Ullgren H. Cancer Prevention Literacy among Different Population Subgroups: Challenges and Enabling Factors for Adopting and Complying with Cancer Prevention Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105888. [PMID: 37239613 DOI: 10.3390/ijerph20105888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/08/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
It is estimated that 40% of the cancer cases in Europe could be prevented if people had better information and tools to make healthier choices and thereby reduce some of the most important cancer risk factors. The aim of this study is to gain knowledge and understanding about cancer prevention literacy among people with intellectual disabilities, immigrants, young people and young cancer survivors. In this qualitative study, we conducted six online focus-group interviews, including forty participants, to explore the cancer prevention literacy of four population subgroups and determine how cancer prevention recommendations according to the European Code Against Cancer (ECAC) were perceived. The analysis resulted in the following main categories: current health beliefs and their impacts on how the ECAC recommendations were perceived, communication strategies and sources benefiting or hindering cancer prevention information from reaching out, and how vulnerabilities in these subgroups impact cancer prevention literacy. To improve cancer prevention literacy in Europe, more attention is needed this topic to overcome barriers among different population subgroups. Recommendations include improved and adapted cancer prevention information, support to individuals, as well as societal support, such as easy-access screening and vaccination programmes and regulations related to tobacco, alcohol, and diet.
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Affiliation(s)
- Lena Sharp
- Regional Cancer Centre, Stockholm-Gotland, SE-10425 Stockholm, Sweden
- Department of Nursing, Umeå University, SE-90187 Umeå, Sweden
| | - Nikolina Dodlek
- Department for Oncology, University Hospital Center Osijek, 31000 Osijek, Croatia
- Department of Nursing, Cyprus University of Technology, Limassol 3036, Cyprus
- Nursing and Palliative Care, Faculty for Medicine and Dental Health, 31000 Osijek, Croatia
| | - Diane Willis
- School of Health & Social Care, Edinburgh Napier University, Edinburgh EH11 4BN, UK
| | - Arja Leppänen
- Regional Cancer Centre, Stockholm-Gotland, SE-10425 Stockholm, Sweden
| | - Helena Ullgren
- Department of Nursing, Umeå University, SE-90187 Umeå, Sweden
- ME Head & Neck, Lung & Skin Cancer, Karolinska Comprehensive Cancer Center, SE-17176 Stockholm, Sweden
- Department of Oncology and Pathology, Karolinska Institutet, SE-17177 Stockholm, Sweden
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Heterogeneity in the Utilization of Fecal Occult Blood Testing and Colonoscopy among Migrants and Non-Migrants in Austria: Results of the Austrian Health Interview Survey. GASTROINTESTINAL DISORDERS 2023. [DOI: 10.3390/gidisord5010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Many European studies report lower participation in colorectal cancer screening among migrants than non-migrants. A major limitation of these studies is that usually, the heterogeneity of migrants cannot be accounted for. The aim of this investigation was to examine differences in the utilization of fecal occult blood testing and colonoscopy between non-migrants and the five largest migrant groups residing in Austria using data from the Austrian Health Interview Survey 2019. The two outcomes were compared between non-migrants and migrants using multivariable logistic regression adjusted for socioeconomic and health variables. Migrants from a Yugoslav successor state (OR = 0.61; 95%-CI: 0.44–0.83), Turkish (OR = 0.35; 95%-CI: 0.22–0.55), Hungarian (OR = 0.37; 95%-CI: 0.16–0.82) and German migrants (OR = 0.70; 95%-CI: 0.51–0.98) were less likely to have used a fecal occult blood test compared to non-migrants. Participation in colonoscopy was lower among Turkish migrants (OR = 0.42; 95%-CI: 0.27–0.67) and migrants from a Yugoslav successor state (OR = 0.56; 95%-CI: 0.42–0.75) than among non-migrants. The findings are consistent with studies from other countries and highlight barriers migrants face in accessing the health care system. To address these barriers, the heterogeneity of the population must be taken into account when developing educational materials in order to promote informed decisions about whether or not to participate in colorectal cancer screening.
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