Socioeconomic Inequalities in Colorectal Cancer Screening Participation in Ontario, Canada

Abstract

Objective: This study examines the socioeconomic inequalities in colorectal cancer (CRC) screening within Ontario, Canada. Methods: Employing the 2017-2018, using data from the Canadian Community Health Survey, the study uses the Wagstaff index (WI) and the Erreygers Index (EI) to analyze and decompose income-related inequalities in CRC screening participation among Ontarians. Results: Overall, the CRC screening rate in Ontario was 72.1%, with females at 74.4% and males at 69.6%. The positive values of the WI (0.184; 95% confidence interval [CI]: 0.161 to 0.207) and the EI (0.147; 95% CI: 0.129 to 0.167) indicated a pro-rich inequality in the CRC screening participation. Decomposition analysis revealed that income (71.73%), education (8.20%), and language barriers (4.39%) were major contributors to this inequality. Conclusion: Addressing income-driven inequality in CRC screening is crucial. Strategies targeting low-income residents, educational outreach, and language support are needed to improve access, awareness, and reduce socioeconomic inequalities in screening participation.