The association of demographic and socioeconomic variables with cancer screening participation: a national cross-sectional study of three cancer screening programs in Denmark

Objective To analyze the demographic and socioeconomic determinants of non-participation in cervical, colorectal and breast cancer screening programs in Denmark. Study design and setting We conducted a cross-sectional study involving all women aged 53-65 years residing in Denmark on 31 March 2018, utilizing comprehensive individual data from population registries. Logistic regression models were employed to assess associations between demographic and socioeconomic factors and complete non-participation (participating in zero out of three cancer screening programs) compared with complete participation (participating in all three cancer screening programs), presenting odds ratios (ORs) with 95% confidence intervals (CIs). Both an unadjusted and two adjusted models were applied. Results Significant associations with non-participation in the three cancer screening programs were observed across all demographic and socioeconomic covariates considered. A higher likelihood of complete non-participation was found among women in the oldest age group (OR: 1.46, 95% CI: 1.32-1.62), women living alone (OR: 1.97, 95% CI: 1.78-2.19), women with ≤10 years of education (OR: 1.75, 95% CI: 1.56-1.97), women outside the labor force (OR: 1.51, 95% CI: 1.34-1.70), and women with lower income (low tertile OR: 4.05, 95% CI: 3.59-5.56, middle tertile OR: 1.72, 95% CI: 1.55-1.91). Further, compared with being an ethnic Dane, both Western immigrants (OR:3.06, 95% CI: 2.53-3.71) and non-Western immigrants (OR: 3.03, 95% CI: 2.46-3.73) demonstrated a strong association with non-participation. Conclusions Demographic and socioeconomic variables are significantly associated with non-participation in all three Danish cancer screening programs, particularly affecting women from vulnerable demographic and socioeconomic backgrounds. Future research should prioritize strategies to enhance participation within this subgroup, aiming to alleviate social inequities in cancer screening.