Evidence map›Paper›PMID 40170017›Full record

Observational studyBMC public health2025

The impact of individual and contextual socioeconomic factors on colorectal cancer screening adherence in Turin, Italy: a multilevel analysis.

Stefano Rousset, Elena Strippoli, Carlo Senore, Teresa Spadea, Marco Calcagno, Nicolás Zengarini, Gianluigi Ferrante

Abstract readObservational Study
In one paragraph

Observational study in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stefano RoussetDepartment of Public Health and Paediatrics, Post Graduate School of Medical Statistics, University of Torino, Torino, Italy.
Elena StrippoliEpidemiology Unit, ASL TO3 Piedmont Region, Collegno (TO), Italy.
Carlo SenoreEpidemiology and screening unit, University hospital Città della Salute e della Scienza, CPO, Torino, Italy.
Teresa SpadeaEpidemiology Unit, ASL TO3 Piedmont Region, Collegno (TO), Italy.
Marco CalcagnoEpidemiology and screening unit, University hospital Città della Salute e della Scienza, CPO, Torino, Italy.
Nicolás Zengarini *Epidemiology Unit, ASL TO3 Piedmont Region, Collegno (TO), Italy.
Gianluigi Ferrante *Epidemiology and screening unit, University hospital Città della Salute e della Scienza, CPO, Torino, Italy. gianluigi.ferrante@cpo.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundScreening participation can be influenced by both individual socioeconomic position and contextual factors. In Italy, disparities exist regarding screening adherence, but it is important to understand the specific factors driving these disparities in specific locations according to different screening protocols. The aim of this study is to identify the impact of individual and contextual socio-economic factors on adherence to the organized colorectal cancer screening in the city of Turin, Italy.

methodsRetrospective observational study on the population of assisted residents in Turin, eligible for colorectal screening from January 2010- June 2019. Colorectal screening in Piedmont involved inviting 58-year-old individuals to undergo a flexible sigmoidoscopy (FS) or, in case of non-adherence, a faecal immunochemical test (FIT). The program also included another protocol based directly on FIT as the first test. Adherence to the two screening protocols according to demographic/socioeconomic characteristics and contextual factors was evaluated with multilevel Poisson models.

results90,227 eligible subjects (53% females) were analysed exploring adherence to FS/FIT. Lower likelihood of participation was found among males from High-Migratory-Pressure-Countries (HMPC), subjects with the lowest educational level, unemployed individuals, subjects living in rented houses, living alone/cohabiting and single parents. Among males, retirees and subjects living in more deprived areas participated more. 36,674 subjects (53% females) were analysed exploring adherence to the first FIT invitation. Adherence rate was higher among women (40% vs. 36%). Lower likelihood of participation was found among HMPC immigrants, males with the lowest educational level, people living in rented accommodation, living alone/cohabiting and single parents. Higher participation was found in retirees. In males, no differences were found between subjects living in more and less deprived areas, but a different likelihood of participation was observed across different areas of the city.

conclusionsSocioeconomic and demographic characteristics influence access to organized colorectal screening in Turin. Immigrant status, low level of education, poor housing conditions and lack of social support, with some differences according to gender, emerged as the most significant barriers that should be tackled in order to increase screening participation and reduce inequalities. Contextual factors play a role only among male subjects.

Indexed as

Colorectal NeoplasmsEarly Detection of CancerPatient ComplianceSocioeconomic FactorsAgedFemaleHumansItalyMaleMiddle AgedMultilevel AnalysisOccult BloodRetrospective StudiesSigmoidoscopyColorectal cancerContextual factorsOrganized screeningSocial inequalitiesSocioeconomic position

Identifiers

PMID40170017
PMCPMC11963395

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.