Inequalities in Colorectal Cancer Screening: Combining MAIHDA with Difference-in-Differences to Assess Programme Effects Across Population Subgroups
Rattachement africain : us, ch, gb, be. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Abstract Background Research consistently shows that colorectal cancer (CRC) screening uptake is socially patterned; however, sociodemographic determinants are usually analysed separately, overlooking how multiple social conditions jointly shape inequalities. This also applies to policy research, where heterogeneity in screening programme effects remains underexplored. Methods Using data from the European Health Interview Survey (2014 and 2019; n=201,214; 24 countries), we applied Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to analyse CRC screening uptake across 72 subgroups defined by sex, education, living arrangement and employment. To assess heterogeneity in screening programme effects, we combined MAIHDA with difference-in-differences (MAIHDA-DiD). Results MAIHDA revealed inequalities in uptake: lower- and middle-educated men, whether employed or unemployed, had the lowest uptake, whereas men and women not living alone, retired or living with disability, had the highest uptake. Lower-educated homemaker women were the only female group with below-average uptake. MAIHDA-DiD showed that programmes increased overall uptake but did not produce larger gains among groups with lower pre-intervention uptake, and therefore did not reduce inequalities. Instead, programmes generated above-average increases among groups with higher pre-intervention uptake, particularly lower- and middle-educated men and women not living alone and retired. Living arrangement explained more variation in programme effects than other factors, with individuals living alone benefiting less from the programmes. Conclusion CRC programmes did not reduce (and may have widened) inequalities, underscoring the need for equity-focused strategies in population-based screening. By extending MAIHDA with difference-in-differences, this study introduces a novel approach for evaluating heterogeneous policy effects in public health.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Inequalities in Colorectal Cancer Screening: Combining MAIHDA with Difference-in-Differences to Assess Programme Effects Across Population Subgroups
- Date Crossref
- 18/07/2026
- Éditeur
- openRxiv
- Type
- posted-content
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Harvard University pays non établi dans la noticeUniversité ou école supérieure
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University of Fribourg Population Health Laboratory (#PopHealthLab) pays non établi dans la noticeUniversité ou école supérieure
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University of Sheffield pays non établi dans la noticeUniversité ou école supérieure
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Ghent University Department of Sociology pays non établi dans la noticeUniversité ou école supérieure
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University of Geneva Institute of Sociological Research pays non établi dans la noticeUniversité ou école supérieure
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FORS – Swiss Centre of Expertise in the Social Sciences pays non établi dans la noticeStructure de recherche
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Sheffield Hallam University pays non établi dans la noticeUniversité ou école supérieure
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Harvard T.H. Chan School of Public Health Department of Social and Behavioral Sciences pays non établi dans la noticeUniversité ou école supérieure
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School of Sociological Studies pays non établi dans la noticeUniversité ou école supérieure
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Swiss Centre of Expertise in Life Course Research LIVES pays non établi dans la noticeInstitution
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School of Education Sheffield Methods Institute pays non établi dans la noticeUniversité ou école supérieure
Harvard University, Population Health Laboratory (#PopHealthLab) — University of Fribourg et University of Sheffield, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.