title: Colorectal Cancer Screening in Switzerland: Cross-Sectional Trends (2007-2012) in Socioeconomic Disparities.
abstract: BACKGROUND
  Despite universal health care coverage, disparities in colorectal cancer (CRC) screening by income in Switzerland have been reported. However, it is not known if these disparities have changed over time. This study examines the association between socioeconomic position and CRC screening in Switzerland between 2007 and 2012.
  
  
  METHODS
  Data from the 2007 (n = 5,946) and 2012 (n = 7,224) population-based Swiss Health Interview Survey data (SHIS) were used to evaluate the association between monthly household income, education, and employment with CRC screening, defined as endoscopy in the past 10 years or fecal occult blood test (FOBT) in the past 2 years. Multivariable Poisson regression was used to estimate prevalence ratios (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status, and health utilization.
  
  
  RESULTS
  CRC screening increased from 18.9% in 2007 to 22.2% in 2012 (padjusted: = 0.036). During the corresponding time period, endoscopy increased (8.2% vs. 15.0%, padjusted:<0.001) and FOBT decreased (13.0% vs. 9.8%, padjusted:0.002). CRC screening prevalence was greater in the highest income (>$6,000) vs. lowest income (≤$2,000) group in 2007 (24.5% vs. 10.5%, PR:1.37, 95%CI: 0.96-1.96) and in 2012 (28.6% vs. 16.0%, PR:1.45, 95%CI: 1.09-1.92); this disparity did not significantly change over time.
  
  
  CONCLUSIONS
  While CRC screening prevalence in Switzerland increased from 2007 to 2012, CRC screening coverage remains low and disparities in CRC screening by income persisted over time. These findings highlight the need for increased access to CRC screening as well as enhanced awareness of the benefits of CRC screening in the Swiss population, particularly among low-income residents.
authors.affiliation: Emory University, Department of Epidemiology, Atlanta, GA, United States of America; American Cancer Society, Atlanta, GA, United States of America.
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Fedewa
authors.affiliation: Unit of population epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cullati
authors.affiliation: Geneva Cancer Registry, Global Health Institute, University of Geneva, Geneva, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Bouchardy
authors.affiliation: Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Ida
authors.initials: I
authors.lastname: Welle
authors.affiliation: Department of Sociology, University of Geneva, Geneva, Switzerland.
authors.forename: Claudine
authors.initials: C
authors.lastname: Burton-Jeangros
authors.affiliation: Unit of population epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland; School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel.
authors.forename: Orly
authors.initials: O
authors.lastname: Manor
authors.affiliation: Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland.
authors.forename: Delphine S
authors.initials: DS
authors.lastname: Courvoisier
authors.affiliation: Emory University, Department of Epidemiology, Atlanta, GA, United States of America; Unit of population epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland; Division of Chronic Disease, University Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Idris
authors.initials: I
authors.lastname: Guessous
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D054625:Healthcare Disparities; D006801:Humans; D012923:Social Class; D013557:Switzerland