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@ARTICLE{Ola:289944,
      author       = {I. Ola$^*$ and R. Cardoso$^*$ and M. Hoffmeister$^*$ and H.
                      Brenner$^*$},
      title        = {{U}tilization of colorectal cancer screening tests across
                      {E}uropean countries: a cross-sectional analysis of the
                      {E}uropean health interview survey 2018–2020},
      journal      = {The lancet / Regional health. Europe},
      volume       = {41},
      issn         = {2666-7762},
      address      = {[Amsterdam]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2024-00926},
      pages        = {100920},
      year         = {2024},
      note         = {#EA:C070#LA:C070#LA:C120#},
      abstract     = {Background:Colorectal cancer (CRC) screening has been shown
                      to reduce CRC incidence and mortality, and most European
                      countries have started to implement CRC screening programs
                      in the past 20 years. Consequently, this study aimed to
                      estimate the utilization of fecal tests and colonoscopy, as
                      well as investigate factors associated with their
                      utilization based on specific screening program
                      characteristics in European countries.Methods:We analyzed
                      data from the European Health Interview Survey 2018–2020
                      to determine the utilization of fecal tests [guaiac-based
                      fecal occult blood test (gFOBT) or fecal immunochemical test
                      (FIT)] within the preceding 2 years or colonoscopy within
                      the preceding 10 years among people aged 50–74 years,
                      based on the type of screening offered in each country.
                      Using multivariable logistic regression and sub-group
                      meta-analysis, factors associated with screening use were
                      determined.Findings:The analyses included data from 129,750
                      respondents across 29 European countries, with participant
                      counts ranging from 1511 individuals in Iceland to 11,755
                      individuals in Germany. Unit response rates ranged from
                      $22\%$ to $88\%.$ The use of either test was highest among
                      countries with fully rolled-out programs with fecal tests
                      [from $37.7\%$ (867/2379) in Croatia to $74.9\%$ (2321/3085)
                      in Denmark] and in countries offering colonoscopy as an
                      alternative screening method [from $26.2\%$ (854/3329) in
                      Greece to $75.4\%$ (1192/1760) in Luxembourg]. We observed
                      the lowest utilization of either test in countries with no
                      program or small-scale programs $[6.3\%$ (195/3179) in
                      Bulgaria to $34.2\%$ (722/2144) in Latvia]. Across all types
                      of screening offers, younger age, being without a partner,
                      low education, rural residence, and living in large
                      households were associated with lower utilization, as were
                      poor lifestyle scores and prolonged periods without
                      physician consultation.Interpretation:Our findings point to
                      large disparities and much room for improvement in CRC
                      screening offers and utilization across Europe.},
      cin          = {C070 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      doi          = {10.1016/j.lanepe.2024.100920},
      url          = {https://inrepo02.dkfz.de/record/289944},
}