Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study
Abstract Background We examined colorectal, breast, and prostate cancer screening utilization in eligible populations within three data cross-sections, and identified factors potentially modifying cancer screening utilization in Swiss adults. Methods The study is based on health insurance claims dat...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-020-10079-8 |
| _version_ | 1829481529024184320 |
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| author | Caroline Bähler Beat Brüngger Agne Ulyte Matthias Schwenkglenks Viktor von Wyl Holger Dressel Oliver Gruebner Wenjia Wei Eva Blozik |
| author_facet | Caroline Bähler Beat Brüngger Agne Ulyte Matthias Schwenkglenks Viktor von Wyl Holger Dressel Oliver Gruebner Wenjia Wei Eva Blozik |
| author_sort | Caroline Bähler |
| collection | DOAJ |
| description | Abstract Background We examined colorectal, breast, and prostate cancer screening utilization in eligible populations within three data cross-sections, and identified factors potentially modifying cancer screening utilization in Swiss adults. Methods The study is based on health insurance claims data of the Helsana Group. The Helsana Group is one of the largest health insurers in Switzerland, insuring approximately 15% of the entire Swiss population across all regions and age groups. We assessed proportions of the eligible populations receiving colonoscopy/fecal occult blood testing (FOBT), mammography, or prostate-specific antigen (PSA) testing in the years 2014, 2016, and 2018, and calculated average marginal effects of individual, temporal, regional, insurance-, supply-, and system-related variables on testing utilization using logistic regression. Results Overall, 8.3% of the eligible population received colonoscopy/FOBT in 2014, 8.9% in 2016, and 9.2% in 2018. In these years, 20.9, 21.2, and 20.4% of the eligible female population received mammography, and 30.5, 31.1, and 31.8% of the eligible male population had PSA testing. Adjusted testing utilization varied little between 2014 and 2018; there was an increasing trend of 0.8% (0.6–1.0%) for colonoscopy/FOBT and of 0.5% (0.2–0.8%) for PSA testing, while mammography use decreased by 1.5% (1.2–1.7%). Generally, testing utilization was higher in French-speaking and Italian-speaking compared to German-speaking region for all screening types. Cantonal programs for breast cancer screening were associated with an increase of 7.1% in mammography utilization. In contrast, a high density of relevant specialist physicians showed null or even negative associations with screening utilization. Conclusions Variation in cancer screening utilization was modest over time, but considerable between regions. Regional variation was highest for mammography use where recommendations are debated most controversially, and the implementation of programs differed the most. |
| first_indexed | 2024-12-14T21:29:04Z |
| format | Article |
| id | doaj.art-1fd655fa079a409b8b5fadedc7f88bdb |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-14T21:29:04Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-1fd655fa079a409b8b5fadedc7f88bdb2022-12-21T22:46:43ZengBMCBMC Public Health1471-24582021-01-0121111210.1186/s12889-020-10079-8Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based studyCaroline Bähler0Beat Brüngger1Agne Ulyte2Matthias Schwenkglenks3Viktor von Wyl4Holger Dressel5Oliver Gruebner6Wenjia Wei7Eva Blozik8Department of Health Sciences, Helsana GroupDepartment of Health Sciences, Helsana GroupDepartment of Epidemiology, Epidemiology, Biostatistics & Prevention Institute, University of ZurichDepartment of Epidemiology, Epidemiology, Biostatistics & Prevention Institute, University of ZurichDepartment of Epidemiology, Epidemiology, Biostatistics & Prevention Institute, University of ZurichDivision of Occupational and Environmental Medicine, Department of Epidemiology, Epidemiology, Biostatistics & Prevention Institute, University of Zurich and University Hospital ZurichDepartment of Epidemiology, Epidemiology, Biostatistics & Prevention Institute, University of ZurichDepartment of Epidemiology, Epidemiology, Biostatistics & Prevention Institute, University of ZurichDepartment of Health Sciences, Helsana GroupAbstract Background We examined colorectal, breast, and prostate cancer screening utilization in eligible populations within three data cross-sections, and identified factors potentially modifying cancer screening utilization in Swiss adults. Methods The study is based on health insurance claims data of the Helsana Group. The Helsana Group is one of the largest health insurers in Switzerland, insuring approximately 15% of the entire Swiss population across all regions and age groups. We assessed proportions of the eligible populations receiving colonoscopy/fecal occult blood testing (FOBT), mammography, or prostate-specific antigen (PSA) testing in the years 2014, 2016, and 2018, and calculated average marginal effects of individual, temporal, regional, insurance-, supply-, and system-related variables on testing utilization using logistic regression. Results Overall, 8.3% of the eligible population received colonoscopy/FOBT in 2014, 8.9% in 2016, and 9.2% in 2018. In these years, 20.9, 21.2, and 20.4% of the eligible female population received mammography, and 30.5, 31.1, and 31.8% of the eligible male population had PSA testing. Adjusted testing utilization varied little between 2014 and 2018; there was an increasing trend of 0.8% (0.6–1.0%) for colonoscopy/FOBT and of 0.5% (0.2–0.8%) for PSA testing, while mammography use decreased by 1.5% (1.2–1.7%). Generally, testing utilization was higher in French-speaking and Italian-speaking compared to German-speaking region for all screening types. Cantonal programs for breast cancer screening were associated with an increase of 7.1% in mammography utilization. In contrast, a high density of relevant specialist physicians showed null or even negative associations with screening utilization. Conclusions Variation in cancer screening utilization was modest over time, but considerable between regions. Regional variation was highest for mammography use where recommendations are debated most controversially, and the implementation of programs differed the most.https://doi.org/10.1186/s12889-020-10079-8Cancer screeningMammographyColonoscopyProstate-specific antigen testingTemporal analysis |
| spellingShingle | Caroline Bähler Beat Brüngger Agne Ulyte Matthias Schwenkglenks Viktor von Wyl Holger Dressel Oliver Gruebner Wenjia Wei Eva Blozik Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study BMC Public Health Cancer screening Mammography Colonoscopy Prostate-specific antigen testing Temporal analysis |
| title | Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study |
| title_full | Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study |
| title_fullStr | Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study |
| title_full_unstemmed | Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study |
| title_short | Temporal trends and regional disparities in cancer screening utilization: an observational Swiss claims-based study |
| title_sort | temporal trends and regional disparities in cancer screening utilization an observational swiss claims based study |
| topic | Cancer screening Mammography Colonoscopy Prostate-specific antigen testing Temporal analysis |
| url | https://doi.org/10.1186/s12889-020-10079-8 |
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