Feeling Healthy, Skipping Screening? Self-Perceived Health and Inequalities in Colorectal Cancer Screening Attendance across European Countries

Sabina Vancikova , Univerzita Karlova
Ivana Kulhánová, The Department of Social Geography and Regional Development Faculty of Science, Charles University

While colorectal cancer (CRC) screening is widely promoted across Europe, social inequalities in its attendance remain a major challenge. Alongside socioeconomic factors, psychological and perceptual aspects, such as self-perceived health (SPH), may influence preventive behavior. However, the role of SPH in CRC screening attendance has received little attention. Using data from the third wave of the European Health Interview Survey (EHIS 2019), we analyzed CRC screening attendance among individuals aged 50–74 across 29 European countries. Logistic regression models were run separately for men and women in each country, with SPH (‘very good’ to ‘very bad’) as the main predictor, controlling for age and education. Additional pooled models including all countries were stratified by education level to examine the robustness of the association. SPH was a statistically significant predictor of CRC screening non-attendance in about half of the tested European countries for both men and women. A consistent gradient emerged: individuals with worse SPH had lower odds of screening non-attendance than those reporting ‘very good’ health. In the pooled model, this inverse association was highly significant across all educational groups, indicating that SPH affects screening behavior independently of educational attainment. Subjective health status appears to be an important and independent factor shaping CRC screening behavior across Europe. Interventions aimed at increasing screening uptake may benefit from addressing these barriers and the misperception of personal risk among those who feel healthy.

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 Presented in Session 86. Health Behaviours and Lifestyke Determinants of Wellbeing