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Title: Socioeconomic factors affecting colorectal, breast and cervical cancer screening in an Asian urban low-income setting at baseline and post-intervention
Authors: Wee, L.E.
Koh, G.C.H. 
Chin, R.T.
Yeo, W.X.
Seow, B.
Chua, D.
Keywords: Breast cancer
Cervical cancer
Colorectal cancer
Low socioeconomic status
Issue Date: Jul-2012
Citation: Wee, L.E., Koh, G.C.H., Chin, R.T., Yeo, W.X., Seow, B., Chua, D. (2012-07). Socioeconomic factors affecting colorectal, breast and cervical cancer screening in an Asian urban low-income setting at baseline and post-intervention. Preventive Medicine 55 (1) : 61-67. ScholarBank@NUS Repository.
Abstract: Background: Inequalities in cancer screening are little studied in Asian societies. We determined whether area and individual measures of socio-economic status (SES) affected cancer screening participation in Singapore and prospectively evaluated an access-enhancing community-based intervention. Methods: The study population involved all residents aged > 40. years in two housing estates comprising of owner-occupied (high-SES area) and rental (low-SES area) flats. From 2009 to 2011, non-adherents to regular screening for colorectal/breast/cervical cancer were offered free convenient screening over six months. Pre- and post-intervention screening rates were compared with McNemar's test. Multi-level logistic regression identified factors of regular screening at baseline; Cox regression analysis identified predictors of screening post-intervention. Results: Participation was 78.2% (1081/1383). In the low-SES area, 7.7% (33/427), 20.4% (44/216), and 14.3% (46/321) had regular colorectal, cervical and breast cancer screening respectively. Post-intervention, screening rates in the low-SES area rose significantly to 19.0% (81/427), 25.4% (55/216), and 34.3% (74/216) respectively (p< 0.001). Area SES was more consistently associated with screening than individual SES at baseline. Post-intervention, for colorectal cancer screening, those with higher education were more likely to attend (p= 0.004); for female cancer screening, the higher-income were less likely to attend (p= 0.032). Conclusions: Access-enhancing community-based interventions improve participation among disadvantaged strata of Asian societies. © 2012 Elsevier Inc..
Source Title: Preventive Medicine
ISSN: 00917435
DOI: 10.1016/j.ypmed.2012.04.011
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