Purpose: This study explores factors associated with non-attendance at diabetic retinal screening in Northland, New Zealand. Method: A retrospective, register-based cross-sectional analysis of 9066 participants invited to diabetic retinal screening in Northland between 17 June 2015 and 17 June 2020 was performed. Multivariate logistic regression was used to assess the risk of age, sex, ethnicity, social deprivation and type of diabetes with non-attendance at diabetic retinal screening. Results: Median age was 65 years (interquartile range 55-74) and 54.6 of participants were male (n = 4947). In total 1974 people (21.8) did not attend their first invited appointment for diabetic retinal screening during the study period. In the multivariable analysis older age was associated with a lower odds of non-attendance (odds ratio OR 0.30, 95 confidence interval CI 0.22-0.40 of non-attendance in those aged over 75 years compared with those aged under 35 years, p value for trend <0.001). Maori (OR 2.82, 95 CI 2.48-3.21) and Pacific Peoples (OR 2.48, 95 CI 1.75-3.51) had a higher odds of non-attendance compared with Europeans. Sex, social deprivation and type of diabetes were not associated with non-attendance. Conclusion: Younger age and Maori and Pacific ethnicity were significant risk factors for non-attendance at diabetic retinal screening. This is the first study exploring social deprivation as a risk factor for non-attendance at diabetic retinal screening in New Zealand, with no association being found, in contrast with findings from other countries. Future qualitative research should explore barriers to screening in groups with high non-attendance rates and measures to increase screening uptake.
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