Social Determinants of Health and Uptake of Colorectal Cancer Screening in Canada
Abstract
Colorectal cancer (CRC) screening uptake may be associated with social determinants of health and could indicate potential barriers to health service access. The goal of this thesis was to evaluate the association of social determinants with CRC screening in screen-eligible adults. We used Andersen’s Behavioural Model of Health Service Utilization and the PROGRESS-Plus Framework to conceptualize potential social determinants. Our first study was a systematic review of peer-reviewed Canadian studies, and the second was a cross-sectional analysis of data from the Canadian Longitudinal Study on Aging (CLSA). The systematic review found lower uptake was associated with non-White ethno-racial identity, less than post-secondary education, and low income. The cross-sectional analysis found lower odds of uptake for younger age, female sex, lower income, partial retirement, no recent contact with a family physician, and fair self-rated general health. We recommend future research on the role of tailored interventions to address disparities in uptake.