Attitude to Secondary Prevention and Concerns about Colonoscopy Are Independent Predictors of Acceptance of Screening Colonoscopy

Abstract

Background: Colonoscopy in combination with endoscopic polypectomy has been shown to be an efficient measure for reducing colorectal cancer incidence. In Germany, a colorectal cancer screening program based on colonoscopy for individuals aged 55 and above was introduced in 2002. However, for largely unknown reasons, participation rates remain low. The purpose of this study was to identify factors influencing compliance with colorectal cancer screening. Methods: A structured survey of 239 individuals aged 55–79 years was performed. Statistical analysis included χ² test, t test, principal component analysis, and logistic regression. Results: 56% of previously screened, but only 26% of non-screened individuals had received a recommendation to undergo screening colonoscopy. 50% of the non-screened believed a screening colonoscopy should only be performed in case of complaints. Univariate analysis identified participation in any secondary prevention measures (p < 0.001), concerns about colonoscopy (p < 0.012), and knowledge about colorectal cancer (p < 0.001) as critical issues distinguishing between groups. Multivariate analysis revealed that secondary prevention (p < 0.001) and concerns about colonoscopy (p = 0.026) were independent predictors of compliance with screening recommendations. Conclusion: Our survey has identified critical factors deterring compliance with colorectal cancer screening recommendations. This will help to direct future campaigns in order to increase participation in colorectal cancer screening.

Capsule colonoscopy increases uptake of colorectal cancer screening

“…A variety of media campaigns [6] and other initiatives have led to only small and brief bursts of interest. The reasons for the limited take-up of CRC screening, especially of colonoscopy, are diverse and not fully known; some recent studies have looked into the issue of barriers to CRC screening in general, the acceptability of various tests and potential measures to improve participation [7-16]. Apart from general doubts and fears, factors such as perception of faecal occult blood testing (FOBT) as unpleasant and colonoscopy as painful may have contributed to the lack of uptake.…”

Health and well‐being among physicians

“…Previous research has revealed that individuals with a higher Physicians' well-being level of education and those with better health status are less likely to undergo a screening colonoscopy. 27 In the present study, 95% of female physicians and 83% of male physicians older than 45 years had never had a colonoscopy. The stigma or awkwardness of having a colonoscopy may explain why many informed individuals choose not to undergo this procedure.…”

“…Although screening is widely touted by authoritative healthcare groups as a valuable preventive tool for certain diseases, and evidence exists of its costeffectiveness, screening rates remain far below those necessary to attain a reduction in mortality. [20][21][22][23][24][25][26][27] Numerous barriers to screening have been identified, including poor patient compliance, lack of provider encouragement, lack of time, lack of awareness of the importance of screening, patients' lack of motivation, patient dislike or refusal, and lack of healthcare coverage. [4][5][6][7][8][9][10][11] Several studies have reported that lack of healthcare provider recommendation is the primary reason for low cancer screening participation.…”

Opportunistic Screening of Hospital Staff Using Primary Colonoscopy: Participation, Discomfort and Willingness to Repeat the Procedure

“…This is comparable to the retrospective survey on attitude to secondary prevention and colonoscopy screening participation, reporting a high proportion of participants regarding screening and consultation as important [38]. Data on reasons to participate from other populations are limited, mostly survey-based, and the majority does not evaluate colonoscopy screening.…”