Preventive medicine最新文献

{"title":"Evaluating the predictive performance of different data sources to forecast overdose deaths at the neighborhood level with machine learning in Rhode Island","authors":"John C. Halifax ,&nbsp;Bennett Allen ,&nbsp;Claire Pratty ,&nbsp;Victoria Jent ,&nbsp;Alexandra Skinner ,&nbsp;Magdalena Cerdá ,&nbsp;Brandon D.L. Marshall ,&nbsp;Daniel B. Neill ,&nbsp;Jennifer Ahern","doi":"10.1016/j.ypmed.2025.108276","DOIUrl":"10.1016/j.ypmed.2025.108276","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the predictive performance of different data sources to forecast fatal overdose in Rhode Island neighborhoods, with the goal of providing a template for other jurisdictions interested in predictive analytics to direct overdose prevention resources.</div></div><div><h3>Methods</h3><div>We evaluated seven combinations of data from six administrative data sources (American Community Survey (ACS) five-year estimates, built environment, emergency medical services non-fatal overdose response, prescription drug monitoring program, carceral release, and historical fatal overdose data). Fatal overdoses in Rhode Island census block groups (CBGs) were predicted using two machine learning approaches: linear regressions and random forests embedded in a nested cross-validation design. We evaluated performance using mean squared error and the percentage of statewide overdoses captured by CBGs forecast to be in top percentiles from 2019 to 2021.</div></div><div><h3>Results</h3><div>Linear models trained on ACS data combined with one other data source performed well, and comparably to models trained on all available data. Those including emergency medical service, prescription drug monitoring program, or carceral release data with ACS data achieved a priori goals for percentage of statewide overdoses captured by CBGs prioritized by models on average.</div></div><div><h3>Conclusions</h3><div>Prioritizing neighborhoods for overdose prevention with forecasting is feasible using a simple-to-implement model trained on publicly available ACS data combined with only one other administrative data source in Rhode Island, offering a starting point for other jurisdictions.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108276"},"PeriodicalIF":4.3,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The associations of long working hours and unhealthy diet with cardiometabolic outcomes and mortality in US workers","authors":"Xiang Li ,&nbsp;Jian Li ,&nbsp;Xuyuehe Ren ,&nbsp;Tong Xia ,&nbsp;Onyebuchi A. Arah ,&nbsp;Liwei Chen","doi":"10.1016/j.ypmed.2025.108275","DOIUrl":"10.1016/j.ypmed.2025.108275","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine independent and joint associations of long working hours (LWH) and EAT-Lancet diet with cardiometabolic outcomes and mortality in US workers.</div></div><div><h3>Methods</h3><div>This prospective cohort included US workers from the National Health and Nutrition Examination Survey, with cross-sectional baseline data from 1999 to March 2020. A subsample of participants from 1999 to 2018 was linked to the National Death Index, with mortality follow-up through December 2019. The independent and joint associations of LWH (≥ 55 vs. &lt; 55 h/week) and EAT-Lancet diet scores (low vs. high) with cardiometabolic outcomes and mortality were estimated using multivariable logistic and Cox proportional hazards models, respectively.</div></div><div><h3>Results</h3><div>LWH was associated with higher odds of obesity (OR = 1.20; 95%CI = 1.07, 1.34) among all workers and higher CVD mortality among workers with high CVD risk at baseline (HR = 1.64, 95%CI = 0.79, 3.12). Low diet scores were associated with higher odds of obesity (OR = 1.34, 95%CI = 1.21, 1.42) and diabetes (OR = 1.33, 95%CI = 1.01, 1.76) among all workers. Working hours and diet scores were jointly associated with obesity and CVD mortality, indicating by the relative excess risk due to interaction greater than zero among all workers.</div></div><div><h3>Conclusions</h3><div>LWH and unhealthy diet are independent risk factors and may interact to exacerbate adverse cardiometabolic health outcomes.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"195 ","pages":"Article 108275"},"PeriodicalIF":4.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the mediating role of Charlson comorbidity index in the association between body mass index and depression in U.S. adults: NHANES 2007–2020","authors":"Xianling Liu ,&nbsp;Wei Zheng ,&nbsp;Yan Sun ,&nbsp;Yansong Li ,&nbsp;Yiting Pan ,&nbsp;Kai Wang ,&nbsp;Miao Lu ,&nbsp;Di Xu","doi":"10.1016/j.ypmed.2025.108273","DOIUrl":"10.1016/j.ypmed.2025.108273","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship among body mass index (BMI), Charlson comorbidity index (CCI), and depression forms a complex interplay that affects both physical and mental health. However, whether CCI mediates the association between BMI and depression remains unclear. In this study, we aimed to elucidate the mediating role of CCI in the relationship between BMI and depression.</div></div><div><h3>Methods</h3><div>This study used data from the National Health and Nutrition Examination Survey, a program of the National Center for Health Statistics in the United States, including 23,639 participants from 2007 to 2020. Wilcoxon rank-sum and Rao-Scott adjusted chi-square tests were employed to compare characteristics between adults with and without depression. Weighted logistic regression and restricted cubic spline models were applied to investigate the pairwise associations among BMI, CCI, and depression. Mediation analysis was performed to assess whether CCI mediated the relationship between BMI and depression.</div></div><div><h3>Results</h3><div>Of the 23,639 participants, 2128 (9.0 %) had depression. Significant associations were observed between BMI and CCI; CCI and depression; and BMI and depression (<em>P</em> &lt; 0.001). A U-shaped relationship between BMI and depression odds was identified, with the lowest odds at a BMI of 23 kg/m². Mediation analysis revealed that CCI partially mediated the BMI-depression relationship, accounting for 19.5 % of the total effect.</div></div><div><h3>Conclusions</h3><div>The results suggest that CCI plays a mediating role in the association between BMI and depression, and that improved chronic disease management may be associated with lower odds of depression in high BMI populations.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108273"},"PeriodicalIF":4.3,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial factors and associations with preventive cardiovascular screening among U.S adults: Findings from the National Health Interview Survey, 2023","authors":"Osayande Agbonlahor,&nbsp;Abigail Gamble,&nbsp;Caroline Compretta,&nbsp;Joshua R. Mann,&nbsp;Fazlay Faruque","doi":"10.1016/j.ypmed.2025.108272","DOIUrl":"10.1016/j.ypmed.2025.108272","url":null,"abstract":"<div><h3>Objective</h3><div>Structural and COVID-related factors have been linked with the decline in preventive health screenings among adults. However, associations between psychosocial factors and undergoing preventive cardiovascular screening are not fully known. The current study examined associations between psychosocial factors and preventive cardiovascular screening among U.S. adults.</div></div><div><h3>Methods</h3><div>We used data from the 2023 National Health Interview Survey (<em>N</em> = 23,428). Data were collected from January to December from adults living in U.S. Preventive cardiovascular (CV) screening (i.e., blood pressure, cholesterol, or blood sugar level) was defined as no screening, and undergoing screening for any CV risk within the past year. Psychosocial factors were defined as discrimination, life satisfaction, and depression. Multivariable logistic regression models examined the associations between psychosocial factors and preventive cardiovascular screening, adjusted for sociodemographic characteristics.</div></div><div><h3>Results</h3><div>Adults with diagnosis of depression (OR: 1.93, 95 % CI: 1.65–2.25) had higher odds of undergoing screening for any CV risk. Adults who experienced discrimination had lower odds of undergoing screening for cholesterol (OR: 0.77, 95 % CI: 0.71–0.84) and blood sugar level specifically (OR: 0.78, 95 % CI: 0.72–0.85), while life dissatisfaction was associated with lower odds of screening for blood pressure (OR: 0.76, 95 % CI: 0.58–0.99) and blood sugar level specifically (OR: 0.80, 95 % CI: 0.65–0.97).</div></div><div><h3>Conclusions</h3><div>Discrimination and life dissatisfaction were associated with decreased odds of undergoing specific preventive cardiovascular screening, and depression is associated with increased odds of undergoing any preventive cardiovascular screening. Equitable health care policies focused on addressing psychosocial factors are needed to increase preventive cardiovascular screening among U.S. adults.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108272"},"PeriodicalIF":4.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical cancer screening and risk factor prevalence by sexual identity: A comparison across three national surveys in the United States","authors":"Jennifer C. Spencer ,&nbsp;Hanwen Zhang ,&nbsp;Brittany M. Charlton ,&nbsp;Phillip W. Schnarrs ,&nbsp;Felicitas Kuehne ,&nbsp;Uwe Siebert ,&nbsp;Amy Trentham-Dietz ,&nbsp;Navkiran K. Shokar ,&nbsp;Jane J. Kim ,&nbsp;Michael P. Pignone","doi":"10.1016/j.ypmed.2025.108262","DOIUrl":"10.1016/j.ypmed.2025.108262","url":null,"abstract":"<div><h3>Objectives</h3><div>Women identifying as lesbian, gay, bisexual, or queer (LGBQ) have lower cervical cancer screening use and differences in care access. Less known about how differences vary by data sources and within LGBQ subgroups. We evaluated LGBQ disparities in cervical cancer screening use and risk factors across three national surveys in the United States.</div></div><div><h3>Methods</h3><div>Data were from the 2019 and 2021 National Health Interview Survey, the 2018 and 2020 Behavioral Risk Factor Surveillance Survey, and the 2017–2019 National Survey of Family Growth. We meta-analyzed self-reported cervical cancer screening to estimate pooled relative risks (pRR), comparing those identifying as LGBQ to those identifying as straight/heterosexual. We also evaluated differences in care access and behavioral risk factors by sexual identity.</div></div><div><h3>Results</h3><div>Despite demographic differences across surveys, all three surveys demonstrated a small reduction in up-to-date cervical cancer screening for LGBQ vs. straight/heterosexual women (pRR = 0.91 [CI 0.89–0.93]). The screening gap was larger for gay/lesbian (pRR: 0.90 [0.85–0.94]) than bisexual women (pRR: 0.94 [0.92–0.97]) and largest at younger ages (pRR age 21–29: 0.89 [CI 0.85–0.93]). LGBQ women reported consistently lower access to care across multiple measures. Risk factors were mixed, including higher smoking rates and higher HPV vaccination coverage for LGBQ women vs. straight.</div></div><div><h3>Discussion</h3><div>LGBQ women are less likely to be screened for cervical cancer. Closing disparities in care access and identifying feasible and acceptable screening interventions will help reduce these disparities. We must also ensure high-quality data collection to monitor disparities across and within key subgroups.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108262"},"PeriodicalIF":4.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of local cigar pack regulations on cigar retail sales","authors":"Jessica King Jensen ,&nbsp;Sunday Azagba ,&nbsp;Alperen Korkmaz ,&nbsp;Cristine D. Delnevo","doi":"10.1016/j.ypmed.2025.108260","DOIUrl":"10.1016/j.ypmed.2025.108260","url":null,"abstract":"<div><h3>Objective</h3><div>Municipalities across the United States have enacted minimum cigar pack size and price policies to curb the sales of inexpensive, small cigars. However, there is limited research evaluating the effectiveness of these policies.</div></div><div><h3>Methods</h3><div>This study used Nielsen sales data from 2011 to 2020, aggregated by market region and half-year. A difference-in-differences approach was used to estimate the average treatment effect on the treated, which is cigar dollar sales compared to what they would have been without such a policy. Analyses included overall sales, as well as sales of flavored and unflavored cigar sales.</div></div><div><h3>Results</h3><div>The analyses revealed a significant decrease in cigar sales associated with the policies. The overall average treatment effect on the treated (ATET), indicated a reduction in sales compared to what their sales would have been without the policies (ATET = −$204,287.7, <em>p</em> &lt; .001). Specifically, the New York market experienced a substantial decline in sales (ATET = −$247,621.8, p &lt; .001), as did the Boston/Manchester market (ATET = −$123,810.2, p &lt; .001). These reductions were consistent for both flavored and unflavored cigars.</div></div><div><h3>Conclusion</h3><div>Local minimum cigar pack policies were associated with reduced cigar sales overall and across cigar flavor types. The study highlights the importance of regulations that address the price and packaging of cigars. The findings contribute to the growing body of evidence supporting the impact of local cigar policies on reducing cigar use and suggest their potential for successful adoption in other localities, which could improve public health outcomes.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108260"},"PeriodicalIF":4.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between specific types of physical activities and cardiometabolic biomarkers: A comparative analysis between metabolic equivalent of task score and biomarker-weighted activity score in relation to type 2 diabetes in US health professionals","authors":"Yiwen Zhang ,&nbsp;Dong Hoon Lee ,&nbsp;Leandro F.M. Rezende ,&nbsp;Edward L. Giovannucci","doi":"10.1016/j.ypmed.2025.108261","DOIUrl":"10.1016/j.ypmed.2025.108261","url":null,"abstract":"<div><h3>Objective</h3><div>To examine specific physical activities' associations with biomarkers and compare metabolic equivalent of task (MET) score with biomarker-weighted score for type 2 diabetes (T2D) risk.</div></div><div><h3>Methods</h3><div>We used data from three large US prospective cohorts (1988/1991–2018/2019). Nine activities - walking, jogging, running, bicycling, lap swimming, tennis/squash, other aerobics, weightlifting, and heavy outdoor work - were assessed biennially. Biomarker analysis included 25,438 participants with data on C-peptide, C-reactive protein (CRP), intercellular adhesion molecule 1, leptin/adiponectin, and triglycerides/high-density lipoprotein cholesterol (TG/HDL). T2D risk analysis involved 183,892 participants followed for up to 30 years. Models were adjusted for confounders and total physical activity excluding the one of interest.</div></div><div><h3>Results</h3><div>Running demonstrated the strongest association with a healthier cardiometabolic profile, followed by jogging, aerobics and weightlifting. For every one hour/week of running, the percent difference in concentration was −4.4 % for C-peptide, −6.6 % for CRP, −11.5 % for leptin/adiponectin, and −5.6 % for TG/HDL (all <em>P</em> &lt; 0.001). Adjusting for body mass index (BMI) slightly weakened the associations for these activities but they remained statistically significant. Walking and tennis/squash showed modest biomarker associations and became null after BMI adjustment. No association was observed for bicycling, lap swimming and heavy outdoor work, likely due to lacking intensity data. The biomarker-weighted score (90th vs. 10th of total physical activity, HR = 0.52; 95%CI, 0.50–0.55) had a stronger association with T2D risk than the MET score (HR = 0.61; 95%CI, 0.58–0.63).</div></div><div><h3>Conclusions</h3><div>Types of physical activity had distinct associations with cardiometabolic biomarkers. A biomarker-weighted score performs better than MET score for T2D risk.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"194 ","pages":"Article 108261"},"PeriodicalIF":4.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically meaningful phenotypes among SARS-CoV-2 reinfections: Informing prevention strategies for future pandemics","authors":"Lander Rodriguez-Idiazabal ,&nbsp;Jose M. Quintana ,&nbsp;Julia Garcia-Asensio ,&nbsp;Maria Jose Legarreta ,&nbsp;Nere Larrea ,&nbsp;Irantzu Barrio","doi":"10.1016/j.ypmed.2025.108259","DOIUrl":"10.1016/j.ypmed.2025.108259","url":null,"abstract":"<div><h3>Objective</h3><div>Rapidly phenotyping patients can inform public health action plans in new pandemics. This study aimed to derive meaningful SARS-CoV-2 reinfected patients' phenotypes based on easily-available patient data and explore key epidemiological factors of reinfections.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of a cohort of SARS-CoV-2 reinfected adults from the Basque Country between January 1, 2021 and January 9, 2022. Phenotypes were defined in an unsupervised manner with clustering algorithms, incorporating variables like age, Charlson score, vaccination status and pre-existing treatments and comorbidities. Subsequently, clinical characteristics of phenotypes were compared, and their behavioral differences were evaluated through generalized additive models. Finally, their association with clinical outcomes was assessed.</div></div><div><h3>Results</h3><div>Four phenotypes were identified, which subsequently had a direct relationship with the risk levels for severe COVID-19 outcomes. The highest-risk group, phenotype 4, consisted of older adults −76 years, [62–85] (Median, [Interquartile range])- with multiple comorbidities and extensive baseline medication use. Phenotype 3 was slightly younger −64 years, [58–77]- but presented very low Charlson scores and few comorbidities, representing an intermediate-risk group. Phenotypes 1 and 2 were younger and healthier adults with similar clinical profiles. However, phenotype 1 showed a less protective attitude, with a higher rate of unvaccinated patients and shorter time intervals between infections.</div></div><div><h3>Conclusions</h3><div>We were able to classify reinfected patients into four distinct groups based on easily available variables, and these phenotypes had a direct relationship with COVID-19 clinical outcomes. Thus, rapidly phenotyping infected individuals can serve as a preventive public health strategy during new pandemics.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"193 ","pages":"Article 108259"},"PeriodicalIF":4.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long working hours and cardiovascular risk: A call for focus on healthcare professionals","authors":"Rahim Hirani ,&nbsp;Avery E. Allen ,&nbsp;Mill Etienne","doi":"10.1016/j.ypmed.2025.108258","DOIUrl":"10.1016/j.ypmed.2025.108258","url":null,"abstract":"","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"193 ","pages":"Article 108258"},"PeriodicalIF":4.3,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing participation in Dutch population-based cancer screening programs: Trends from 2018 to 2022","authors":"Brenda J. van Stigt,&nbsp;Ellen M.G. Olthof,&nbsp;Inge M.C.M. de Kok,&nbsp;Eveline A.M. Heijnsdijk,&nbsp;Iris Lansdorp-Vogelaar,&nbsp;Nicolien T. van Ravesteyn,&nbsp;Esther Toes-Zoutendijk","doi":"10.1016/j.ypmed.2025.108257","DOIUrl":"10.1016/j.ypmed.2025.108257","url":null,"abstract":"<div><h3>Objective</h3><div>Population-based screening programs for breast, cervical, and colorectal cancer have been proven effective in detecting cancer at an early or precancerous stage, thereby enabling better patient outcomes. For screening programs to remain effective at a population level, high participation rates are essential.</div></div><div><h3>Methods</h3><div>Data on participation in the three nationwide screening programs in the Netherlands from 2018 to 2022 were obtained from the national screening information system (ScreenIT). Participation rates were calculated to assess trends over time, stratified by invitation round (first vs. subsequent) and sex (for colorectal cancer only).</div></div><div><h3>Results</h3><div>Participation was consistently lower for the first invitation rounds and men compared to subsequent rounds and women. Decreasing participation rates were observed for all programs and subgroups. In five years' time, overall participation decreased from 76.9 % to 70.7 % for breast cancer (−8.0 %), 55.5 % to 48.6 % for cervical cancer (−12.4 %), and 73.0 % to 68.4 % for colorectal cancer (−6.2 %).</div></div><div><h3>Conclusion</h3><div>While some logistical factors may have contributed to decreasing participation rates, the consistent decline observed across all three nationwide screening programs remains unclarified. Our results emphasize that continuous monitoring of screening programs is crucial, and accessibility of cancer screening should be prioritized.</div></div>","PeriodicalId":20339,"journal":{"name":"Preventive medicine","volume":"193 ","pages":"Article 108257"},"PeriodicalIF":4.3,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}