LAUSR

Dear Editor: Deding and colleagues well illustrated sociodemographic predictors of participation in colorectal cancer screening in a large data from Danish population. They truly underlined the role of sociodemographic indicators including regions of residence, genders, age groups, marital statuses, immigration statuses, educational levels, and income quartiles was seen in participating in colorectal cancer screening program in their population [1]. It is documented that inequalities in socioeconomic has been generally associated with a higher mortality due to several types of cancer. Even in Scandinavian countries with proper health care distribution, higher socioeconomic status is associated with decreased overall and cause-specific mortalities [2]. The role of disparities in socioeconomic status becomes more critical among developing countries. There are no such routine screening strategies for most of the non-communicable diseases (NCD) in these countries. On the other hand, implementing a new health care screening program would be encountered with numerous problems due to the low compliance and poor reception of the population [3]. There are different aspects involving in this issue among these countries. The coverage of health care system and health insurance are pivotal factors which is poor in these countries. Besides, the accessibility of equipment for screening is wide different between developed and developing countries and also unequal and unfair inside the developing countries particularly in rural areas. As an example, in the USA, the availability of colonoscopic evaluations leads to the better detection and elimination of precancerous lesions and diagnosis of earlier stage disease. But, in Western Africa, colonoscopy is almost unavailable as a screening tool. Unfortunately, cheaper screening modalities, such as fecal occult blood testing, are scarcely used, either [4]. Due to the gross limitations of resources in these countries, it is necessary to assess the available facilities and estimate the cost effectiveness of the screening programs in each country. Conducting such nationwide programs would not be possible without the national and governmental support which seemed to be not considered in poor countries [5]. It is noteworthy that achieving to any new health care program could not be possible without sensitization of the population by enhancing the knowledge and attitudes of them about the benefits of it. In countries where communicable diseases are still great dilemma for health system, conducting an effective NCD is a matter of further efforts.