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Reasons for non-participation in population-based abdominal aortic aneurysm screening
A Linne1, K Leander, D Lindström
1Section of Vascular Surgery, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Science and Education, Karolinska Institutet at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
The British Journal of Surgery
|March 12, 2014
Summary
Low income, education, and immigrant status were key barriers to abdominal aortic aneurysm (AAA) screening participation. Addressing these factors is crucial for improving screening uptake and identifying at-risk individuals.
Area of Science:
- Vascular Surgery
- Public Health
- Epidemiology
Background:
- A population-based abdominal aortic aneurysm (AAA) screening program was established in Stockholm County, Sweden, in 2010.
- Understanding non-participation is vital for optimizing screening program effectiveness.
Purpose of the Study:
- To identify the primary reasons for non-participation in the Stockholm AAA screening program.
- To analyze socioeconomic factors, travel distance, and healthcare utilization among participants and non-participants.
Main Methods:
- Inclusion of all 65-year-old men invited to AAA screening between July 2010 and July 2012.
- Comparison of participants and non-participants based on socioeconomic status, travel distance, and healthcare use.
- Application of univariable and multivariable logistic regression models to determine factors influencing participation.
Main Results:
- The participation rate was 77.6%, with an AAA prevalence of 1.4% among participants.
- Key predictors of non-participation included recent immigration (OR 3.25), low income (OR 2.76), single/divorced status (OR 2.23), low education (OR 1.28), and long travel distance (OR 1.23).
- Non-participants exhibited higher rates of stroke and chronic pulmonary disease, and daily smoking was more prevalent in low-participation areas.
Conclusions:
- Targeted interventions for low-income individuals, those with lower education levels, and immigrants are recommended to enhance AAA screening participation.
- The elevated morbidity and smoking rates in non-participants suggest a potentially higher risk for AAA in this group, necessitating focused outreach.
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