Meryem Merve Ören Çelik

Determinants of cancer screening participation in Türkiye: a nationwide study of demographic, socioeconomic, and lifestyle factors

Cancer screening participation rates remain low globally, and understanding the factors influencing these rates is crucial for designing effective public health interventions. This study examines the demographic, socioeconomic, and lifestyle determinants of breast, cervical, and colorectal cancer screening participation in Türkiye. This cross-sectional study utilized data from the 2022 Turkish Health Survey, a nationally representative survey conducted by the Turkish Statistical Institute. The survey employed a stratified two-stage cluster sampling method to ensure national representativeness, covering both urban and rural areas of Türkiye. The study population included 5554 women aged 40-69 years for breast cancer screening, 7277 women aged 30-65 years for cervical cancer screening, and 6541 men and women aged 50-70 years for colorectal cancer screening. Multivariate logistic regression models were used to identify factors associated with non-participation in screenings. Key variables included sociodemographic characteristics, health status, healthcare access, and lifestyle factors. The proportions of individuals who had never undergone screening were 54.1% for colorectal, 45.9% for breast, and 51.4% for cervical cancer. Higher education and income levels were associated with increased screening participation across all cancers. Individuals with chronic diseases and those who had visited family physicians in the past year were more likely to be screened. Participation in one cancer screening significantly increased the likelihood of engaging in others. Women who had undergone cervical cancer screening had a 91% lower odds of avoiding breast cancer screening (OR: 0.09; 95% CI: 0.08-0.11). Those who participated in breast or cervical screening had 45-51% lower odds of avoiding colorectal cancer screening. Cancer screening participation is influenced by sociodemographic factors, healthcare access, and engagement in other screenings. Findings highlight the need for targeted interventions, particularly for underserved populations, and coordinated screening strategies to improve participation and reduce disparities.