Barriers to colorectal cancer screening: A case-control study

Abstract

AIM:To investigate barriers to colorectal cancer (CRC) screening in a community population. METHODS:We conducted a community-based case-control study in an urban Chinese population by questionnaire. Cases were selected from those completing both a fecal occult blood test (FOBT) case and colonoscopy in a CRC screening program in 2004. Control groups were matched by gender, age group and community. Control 1 included those having a positive FOBT but refusing a colonoscopy. Control 2 included those who refused both an FOBT and colonoscopy. RESULTS:The impact of occupation on willingness to attend a colorectal screening program differed by gender. P for heterogeneity was 0.009 for case vs control group 1, 0.01 for case versus control group 2, and 0.80 for control group 1 vs 2. Poor awareness of CRC and its screening program, characteristics of screening tests, and lack of time affected the screening rate. Financial support, fear of pain and bowel preparation were barriers to a colonoscopy as a screening test. Eighty-two percent of control group 1 and 87.1% of control group 2 were willing attend if the colonoscopy was free, but only 56.3% and 53.1%, respectively, if it was self-paid. Multivariate odds ratios for case vs control group 1 were 0.10 among those unwilling to attend a free colonoscopy and 0.50 among those unwilling to attend a self-paid colonoscopy. CONCLUSION:Raising the public awareness of CRC and its screening, integrating CRC screening into the health care system, and using a painless colonoscopy would increase its screening rate.

Colorectal cancer screening of the general population in East Asia

“…19 Poor awareness of CRC and its screening, various screening tests, lack of time, fear of colonoscopy and financial issues might be important factors affecting the participation rate. 19 Therefore, efforts should be made to improve the coverage and participation rate of CRC screening in the target population. Generally, improvements in health education, a convenient and acceptable screening procedure, more expansive health insurance coverage, and establishment of a quality assurance system would be effective ways to improve CRC screening quality, and thus reduce CRC mortality, in China.…”

Determinants of participation in colorectal cancer screening among community-dwelling Chinese older people: Testing a comprehensive model using a descriptive correlational study

“…Information regarding the determinants of CRC screening behavior in Chinese populations, however, is scarce. A few studies have been conducted in such populations but none of them has targeted older people and most have focused solely on demographic and health-related variables (Cai et al, 2009;Leung et al, 2012aLeung et al, , 2012bMa et al, 2012;So et al, 2012;Sung et al, 2008;Todd et al, 2011;Wang et al, 2006;Yip et al, 2006). Clearly, little is known about CRC screening participation rates and associated factors among Chinese older people.…”

Serum M2-pyruvate kinase: A promising non-invasive biomarker for colorectal cancer mass screening

“…One of the most important ways to reduce CRC mortality and morbidity is to conduct CRC screening in the population. However, the compliance rate for the immunochemical fecal occult blood test (iFOBT) in a CRC mass screening is not high and is even lower for colonoscopy [5,6] . In order to increase the compliance rate, a screening protocol combining iFOBT with a high risk factors questionnaire (HRFQ) approach as the primary test to screen high risk populations, followed by colonoscopy as a follow-up test to detect CRC and other colorectal diseases, has been recommended by the Department of Disease Prevention and Control, the Ministry of Health of China, for CRC mass screening in China, based on the work of Zheng and her team [7] .…”

“…In order to increase the compliance rate, a screening protocol combining iFOBT with a high risk factors questionnaire (HRFQ) approach as the primary test to screen high risk populations, followed by colonoscopy as a follow-up test to detect CRC and other colorectal diseases, has been recommended by the Department of Disease Prevention and Control, the Ministry of Health of China, for CRC mass screening in China, based on the work of Zheng and her team [7] . This protocol has been used in the China national screening program in the general population in recent years [5,6,8] . The combined HRFQ has improved compliance rate and screening net sensitivity due to the simultaneous screening design and the overall effectiveness of our screening program.…”