Concurrent cancer screening participation and associated factors among Canadian women: Insights from a cross-sectional study
Objectives
Colorectal, breast, and cervical cancers are leading causes of morbidity and mortality among Canadian women. While organized screening programs aim to reduce this burden, participation rates remain suboptimal, particularly for colorectal cancer screening. This study examined factors associated with colorectal cancer screening uptake among women participating in breast and cervical cancer screening ('screen-aware” women), investigated patterns of concurrent participation across all three programs, and identified associated factors.
Methods
Cross-sectional data from the 2017 Canadian Community Health Survey were analyzed for women aged 50–69 eligible for breast cancer (mammography), cervical cancer (Pap smear), and colorectal cancer (fecal and/or endoscopy tests) screening (
n
= 10,426). Multivariable logistic regression evaluated factors associated with colorectal cancer screening among “screen-aware” women. Multinomial logistic regression assessed factors related to full (all three), partial (any two), single, or non-participation across screening programs, using “no screening” as the reference.
Results
Although the majority of women (87%) participated in at least one screening program, only 27% reported full participation. Colorectal cancer screening (53.7%) lagged behind breast and cervical cancer screening (∼64%). Among “screen-aware” women, older age (adjusted odds ratio 1.50, 95% confidence interval 1.31–1.71), higher income, self-rated health as “great” (adjusted odds ratio 1.31, 95% confidence interval 1.05–1.63), and having a regular healthcare provider (adjusted odds ratio 3.29, 95% confidence interval 2.45–4.40) were associated with higher colorectal cancer screening participation. Having multiple chronic conditions reduced colorectal cancer screening likelihood (adjusted odds ratio 0.72, 95% confidence interval 0.55–0.94). Higher income, self-rated health, having a regular healthcare provider, and physical activity increased the odds of full screening participation, while smoking and Asian identity reduced the odds.
Conclusions
Colorectal cancer screening uptake remains low among Canadian women, even those participating in other cancer screenings. Socioeconomic, health-related, and systemic factors influence concurrent screening participation. Tailored interventions addressing identified barriers and promoting equitable access to screening are crucial for improving cancer prevention efforts.
