Health Equity After a Colorectal Cancer Screening Program

作者：Xuechen Xiong, Carmen S. Ng, Yikun Zhang, Jiayi Liang, Jo Yi Chow, SF Pang, Xinyu Du, W-L Law, Wai Keung Leung, Gabriel M. Leung, Jianchao Quan · 发表于：JAMA Health Forum · 年份：2026 · DOI：10.1001/jamahealthforum.2026.1520 · 研究领域：Colorectal Cancer Screening and Detection、Global Cancer Incidence and Screening、Health Promotion and Cardiovascular Prevention

Importance: Colorectal cancer (CRC) is the third most diagnosed cancer and the second leading cause of cancer death globally. Early identification of precancerous lesions and early-stage cancers can substantially reduce CRC incidence and improve survival. Hong Kong launched an organized colorectal cancer screening program (CRCSP) for the population in 2016. Objective: To assess the association of the CRCSP with the health equity of cancer screening participation among different socioeconomic groups over a 9-year period. Design, Setting, and Participants: Individual-level data from adults aged 50 to 75 years were analyzed from 3 repeated territory-wide population surveys in Hong Kong, China, between December 2014 to January 2022 to track trends in fecal test and colonoscopy participation. Disparities in screening uptake by socioeconomic status and income were assessed by concentration curves and indices. Survey-weighted generalized logistic regression models were used to assess the association between screening participation and socioeconomic factors. Data were analyzed from January 2025 to March 2026. Main Outcomes and Measures: Colorectal cancer screening utilization, specifically having ever undergone (1) a fecal test without symptoms and (2) a colonoscopy without symptoms. Results: This study analyzed 14 602 adults aged 50 to 75 years (mean [SD] age, 60.62 [7.03] years; 7716 female individuals [52.84%]). Participation in fecal testing increased from 19.88% (95% CI, 18.70-2...