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Simple Summary: This study uses an individual socioeconomic status index to analyse social inequalities in the Valencia Region Colorectal Cancer Screening Programme. Analysing the social determinants of cancer and ensuring health equity are some of the main challenges faced by developed countries in recent years, and these aspects are also the main focus of policies in many territories. Furthermore, given that the European Commission has highlighted the importance of evaluating inequalities in colorectal cancer (CRC) screening programmes, this study is highly relevant. This paper contributes to the existing literature on inequalities in cancer screening, and the insights provided herein could potentially influence policies and interventions to promote equity in CRC screening programmes. Background/Objectives: An individual socioeconomic status index (ISESI) was used to analyse inequalities in participation and colonoscopy acceptance in the Valencia Region Colorectal Cancer Screening Programme (VR-CRCSP). Methods: This is a cross-sectional study of men and women aged 50–69 who had been invited to participate in the VR-CRCSP as of February 2020 (N = 1,066,763). The variables included in the ISESI were nationality, employment status, disability, healthcare coverage, risk of vulnerability, and family size. The ISESI was categorised into quartiles (Qs), with Q4 corresponding to the lowest socioeconomic status (SES). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using mixed logistic regression models. Results: The results showed that Q2 (OR = 1.30, CI = 1.28–1.33) and Q3 (OR = 1.07, CI = 1.05–1.09) are more likely to participate in the CRCSP than Q1 (the highest SES), and that Q4 (OR = 0.77, CI = 0.76–0.78) is less likely to participate than Q1. In addition, Q2 (OR = 2.03, CI = 1.78–2.32), Q3 (OR = 1.90, CI = 1.67–2.16), and Q4 (OR = 1.55, CI = 1.36–1.76) are more likely to accept a colonoscopy than Q1. The following socioeconomic characteristics were related to both non-participation and colonoscopy refusal: not Spanish, disabled, no family unit, at risk of social vulnerability, and private mutual health insurance. Conclusions: Inequalities were observed in VR-CRCSP participation and colonoscopy acceptance. [ABSTRACT FROM AUTHOR]

Background The recommendation for the implementation of mammography screening in women aged 45–49 and 70–74 is conditional with moderate certainty of the evidence. The aim of this study is to simulate the long-term outcomes (2020–50) of using different age range scenarios in the breast cancer screening programme of the Valencia Region (Spain), considering different programme participation rates. Methods Three age range scenarios (S) were simulated with the EU-TOPIA tool, considering a biennial screening interval: S1, 45–69 years old (y); S2, 50–69 y and S3, 45–74 y. Simulations were performed for four participation rates: A = current participation (72.7%), B = +5%, C = +10% and D = +20%. Considered benefits: number (N°) of in situ and invasive breast cancers (BC) (screen vs. clinically detected), N° of BC deaths and % BC mortality reduction. Considered harms: N° of false positives (FP) and % overdiagnosis. Results The results showed that BC mortality decreased in all scenarios, being higher in S3A (32.2%) than S1A (30.6%) and S2A (27.9%). Harms decreased in S2A vs. S1A (N° FP: 236 vs. 423, overdiagnosis: 4.9% vs. 5.0%) but also benefits (BC mortality reduction: 27.9% vs. 30.6%, N° screen-detected invasive BC 15/28 vs. 18/25). In S3A vs. S1A, an increase in benefits was observed (BC mortality reduction: 32.2% vs. 30.6%), N° screen-detected in situ B: 5/2 vs. 4/3), but also in harms (N° FP: 460 vs. 423, overdiagnosis: 5.8% vs. 5.0%). Similar trends were observed with increased participation. Conclusions As the age range increases, so does not only the reduction in BC mortality, but also the probability of FP and overdiagnosis. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study aims to analyse the relationship between sedentary behaviour and breast cancer (BC) risk from a social perspective. Methods: Women aged 45–70 who participated in the Valencia Region Breast Cancer Screening Programme (2018–2019) were included, with a total of 121,359 women analysed, including 506 with cancer and 120,853 without cancer. The response variable was BC (screen-detected) and the main explanatory variable was sedentary behaviour (≤2 / >2-≤3 / >3-≤5 / >5 hours/day, h/d). Nested logistic regression models (M) were estimated: M1: sedentary behaviour adjusted for age and family history of BC; M2: M1 + hormonal/reproductive variables (menopausal status, number of pregnancies, hormone replacement therapy; in addition, months of breastfeeding was added for a subsample of women with one or more live births); M3: M2 + lifestyle variables (body mass index, smoking habits); M4: M3 + socioeconomic variables (educational level, occupation); Final model: M4 + gender variables (childcare responsibilities, family size). Interaction between sedentary behaviour and educational level was analysed in the Final model. Moreover, for the whole sample, postmenopausal women and HR+ BC, the Final model was stratified by educational level. Results: Sedentary behaviour was associated with an increased risk of BC with a nearly statistically significant effect in the Final model (>2-≤3 h/d: OR = 1.22 (0.93–1.61); >3-≤5 h/d: OR = 1.14 (0.86–1.52); >5: OR = 1.19 (0.89–1.60)). For women with a low educational level, sitting more than 2 h/d was associated with an increased risk of BC in the whole sample (>2-≤3 h/d OR = 1.93 (1.19–3.21); in postmenopausal women (>2-≤3 h/d, OR = 2.12 (1.18–2.96), >5h/d OR = 1.75 (1.01–3.11)) and in HR+ BC (>2-≤3h/d, OR = 2.15 (1.22–3.99)). Similar results were observed for women with one or more live births. Conclusions Sitting >2 h/d is associated with BC risk in women with low educational level, especially in postmenopausal women and those with live births. [ABSTRACT FROM AUTHOR]