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Zeng-Zhang L, de Miguel-Diez J, López-de-Andrés A, Jiménez-García R, Ji Z, Meizoso-Pita O, Sevillano-Collantes C, Zamorano-León JJ. Adherence to Screening Tests for Gynaecological and Colorectal Cancer in Patients with Diabetes in Spain: A Population-Based Study (2014-2020). J Clin Med 2024; 13:3047. [PMID: 38892758 PMCID: PMC11172449 DOI: 10.3390/jcm13113047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: Both diabetes mellitus (DM) and gynaecological and colorectal cancers are highly prevalent diseases. Furthermore, the presence of DM constitutes a risk factor and poor prognostic indicator for these types of cancer. This study is based on the European Health Interview Surveys in Spain (EHISS) of 2014 and 2020. It aimed to determine the trends in adherence to screening tests for gynaecological cancers (breast and cervical) and colorectal cancer, compare adherence levels between populations with and without diabetes, and identify predictors of adherence in the population with diabetes. Methods: An epidemiological case-control study based on the EHISS data of 2014 and 2020 was conducted. The characteristics of participants who underwent screening tests were analysed based on the presence or absence of DM, and predictors of adherence to these preventive activities were identified. Results: A total of 1852 participants with reported DM and 1852 controls without DM, adjusted for age and sex, were included. A higher adherence to mammography was observed in women without diabetes compared to those with diabetes, although statistical significance was not reached (72.9% vs. 68.6%, p = 0.068). Similarly, higher Pap smear adherence was observed in the population without diabetes in the age group between 60 and 69 years compared to the population with diabetes (54.0% vs. 45.8%, p = 0.016). Pap smear adherence among women with diabetes was significantly higher in the EHISS of 2020 (52.0% in 2014 vs. 61.0% in 2020, p = 0.010), as was the case for faecal occult blood testing (13.8% in 2014 vs. 33.8% in 2020, p < 0.001), but it was not significant for mammography (70.4% in 2014 vs. 66.8% in 2020, p = 0.301). Overall, the predictors of adherence to screening tests were older age, history of cancer and higher education level. Conclusions: Adherence levels to cancer screening tests were lower in the population with diabetes compared to those without diabetes, although an improvement in Pap smear and faecal occult blood test adherence was observed in 2020 compared to 2014. Understanding predictors is important to improve adherence rates in the population with diabetes.
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Affiliation(s)
- Luyi Zeng-Zhang
- Endocrinology and Nutrition Department, Infanta Leonor University Hospital, Universidad Complutense de Madrid, 28031 Madrid, Spain; (L.Z.-Z.); (O.M.-P.); (C.S.-C.)
| | - Javier de Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.d.M.-D.); (Z.J.)
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (R.J.-G.); (J.J.Z.-L.)
| | - Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (R.J.-G.); (J.J.Z.-L.)
| | - Zichen Ji
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain; (J.d.M.-D.); (Z.J.)
| | - Olalla Meizoso-Pita
- Endocrinology and Nutrition Department, Infanta Leonor University Hospital, Universidad Complutense de Madrid, 28031 Madrid, Spain; (L.Z.-Z.); (O.M.-P.); (C.S.-C.)
| | - Cristina Sevillano-Collantes
- Endocrinology and Nutrition Department, Infanta Leonor University Hospital, Universidad Complutense de Madrid, 28031 Madrid, Spain; (L.Z.-Z.); (O.M.-P.); (C.S.-C.)
| | - Jose J. Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain; (R.J.-G.); (J.J.Z.-L.)
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Trends and Predictors for the Uptake of Colon Cancer Screening Using the Fecal Occult Blood Test in Spain from 2011 to 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176222. [PMID: 32867168 PMCID: PMC7504712 DOI: 10.3390/ijerph17176222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/22/2020] [Accepted: 08/25/2020] [Indexed: 12/19/2022]
Abstract
Background: In Spain, colorectal cancer screening using the fecal occult blood test, targeted towards the 50–69 age bracket, was implemented on different dates. We aim to assess the temporal trend of colorectal cancer (CRC) screening uptake according to the year of screening implementation in each region and to identify predictors for the uptake of CRC screening. Methods: A cross-sectional study with 12,657 participants from the Spanish National Health Surveys 2011 and 2017 was used. Uptake rates were analyzed according to the date that the screening program was implemented. Results: For regions with programs implemented before 2011, the uptake rate increased 3.34-fold from 2011 to 2017 (9.8% vs. 32.7%; p < 0.001). For regions that implemented screening within the 2011–2016 period, the uptake rose from 4.3% to 13.2% (3.07-fold; p < 0.001), and for regions that implemented screening after 2016, the uptake increased from 3.4% to 8.8% (2.59-fold; p < 0.001). For the entire Spanish population, the uptake increased 3.21-fold (6.8% vs. 21.8%; p < 0.001). Positive predictors for uptake were older age, Spanish nationality, middle-to-high educational level, suffering chronic diseases, non-smoking and living in regions where screening programs were implemented earlier. Conclusions: The different periods for the implementation of CRC screening as well as sociodemographic and health inequalities may have limited the improvement in the screening uptake from 2011 to 2017 in Spain.
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Mirzaei-Alavijeh M, Schaafsma D, Karami-Matin B, Jalilian F. Socio-cognitive determinants of colorectal cancer screening uptake: An application of intervention mapping approach. Med J Islam Repub Iran 2019; 33:80. [PMID: 31696074 PMCID: PMC6825394 DOI: 10.34171/mjiri.33.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Fecal occult blood test (FOBT) is one of the common screening tests for colorectal cancer. This study was designed to determine the socio-cognitive determinants related to FOBT uptake for colorectal cancer screening based on intervention mapping (IM). Methods: A total of 500 individuals aged over 50 years were randomly selected to participate in this study in Kermanshah, Iran, in 2016. Data were collected by interviews based on a questionnaire and analyzed by SPSS16 using bivariate correlation, linear, and logistic regression models. Results: Of the 500 respondents, 468 (93.6%) signed the consent form and voluntarily participated in the study. Almost 11.1% of the participants had a history of FOBT uptake. Socio-cognitive variables accounted for 38% of the variation in the outcome measure of the intention to uptake FOBT. Perceived self-efficacy (OR = 3.345 & 95% CI: 1.342, 8.339), perceived susceptibility (OR = 2.204& 95% CI: 1.320, 3.680), attitude (OR = 1.674& 95% CI: 1.270, 2.137), and perceived severity (OR = 1.457& 95% CI: 0.954, 2.224) were the strongest predictors of fecal occult blood test uptake. Conclusion: IM-based analysis of behavior may provide insights to design interventions for modifying individuals’ beliefs about the usefulness of FOBT uptake to prevent colorectal cancer.
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Affiliation(s)
- Mehdi Mirzaei-Alavijeh
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Dilana Schaafsma
- Fontys University of Applied Sciences, Eindhoven, the Netherlands
| | - Behzad Karami-Matin
- Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farzad Jalilian
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Michopoulos S, Manios E, Kourkoutas H, Argyriou K, Leonidakis G, Zampeli E, Stamatelopoulos K, Dimopoulos AM. Predictors of colorectal cancer screening awareness among people working in a hospital environment. Ann Gastroenterol 2017; 30:315-321. [PMID: 28469362 PMCID: PMC5411382 DOI: 10.20524/aog.2017.0127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/09/2017] [Indexed: 12/22/2022] Open
Abstract
Background Compliance rates for colorectal cancer (CRC) screening are much lower than those desired. Appropriate information on CRC risks and screening methods is supposed to stimulate motivation for screening. We aimed to identify parameters associated with the decision for CRC screening and colonoscopy in a population expected to have high awareness of disease prevention. Methods In a single-center, cross-sectional study, we used an anonymous questionnaire (AQ) to record the demographics, habits and screening behavior for cancers and other common diseases of all employees older than 50 years in our hospital. Results Among 287 active employees, 83% (n=237) answered the AQ (age 55±4 years). Thirty percent (n=70) underwent colonoscopy while 17% (n=40) underwent CRC screening (39/40) colonoscopy). Comparatively, among women 97% had a Pap-smear, 92% a mammography, while among men 83% had been tested for serum prostate-specific antigen. Age, male sex, alcohol consumption and university education correlated positively with CRC screening (P<0.05 for all). After multivariate analysis, university education remained an independent determinant of CRC screening (OR 2.488, 95%CI 1.096-5.648; P=0.029). Among subjects who had not undergone colonoscopy in the past, ignorance of the need for CRC screening (OR 0.360, 95%CI 0.150-0.867; P=0.023) and indifference to undergo such a procedure (OR 0.188, 95%CI 0.066-0.537; P=0.002) were independent determinants for not planning a future screening colonoscopy. Conclusions Education was the most important factor in the decision to undergo CRC screening. Colonoscopy was the preferred screening method. Ignorance of and indifference to CRC risks were the major obstacles for a future screening colonoscopy.
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Affiliation(s)
- Spyridon Michopoulos
- Gastroenterology Unit, "Alexandra" Hospital (Spyridon Michopoulos, Helias Kourkoutas, Konstantinos Argyriou, Georgios Leonidakis, Evanthia Zampeli)
| | - Efstathios Manios
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Alexandra Hospital (Efstathios Manios, Kimon Stamatelopoulos, Athanasios-Meletios Dimopoulos), Athens, Greece
| | - Helias Kourkoutas
- Gastroenterology Unit, "Alexandra" Hospital (Spyridon Michopoulos, Helias Kourkoutas, Konstantinos Argyriou, Georgios Leonidakis, Evanthia Zampeli)
| | - Konstantinos Argyriou
- Gastroenterology Unit, "Alexandra" Hospital (Spyridon Michopoulos, Helias Kourkoutas, Konstantinos Argyriou, Georgios Leonidakis, Evanthia Zampeli)
| | - Georgios Leonidakis
- Gastroenterology Unit, "Alexandra" Hospital (Spyridon Michopoulos, Helias Kourkoutas, Konstantinos Argyriou, Georgios Leonidakis, Evanthia Zampeli)
| | - Evanthia Zampeli
- Gastroenterology Unit, "Alexandra" Hospital (Spyridon Michopoulos, Helias Kourkoutas, Konstantinos Argyriou, Georgios Leonidakis, Evanthia Zampeli)
| | - Kimon Stamatelopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Alexandra Hospital (Efstathios Manios, Kimon Stamatelopoulos, Athanasios-Meletios Dimopoulos), Athens, Greece
| | - Athanasios-Meletios Dimopoulos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Medical School, Alexandra Hospital (Efstathios Manios, Kimon Stamatelopoulos, Athanasios-Meletios Dimopoulos), Athens, Greece
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Al-Naggar RA, Al-Kubaisy W, Yap BW, Bobryshev YV, Osman MT. Attitudes towards colorectal cancer (CRC) and CRC screening tests among elderly Malay patients. Asian Pac J Cancer Prev 2015; 16:667-74. [PMID: 25684505 DOI: 10.7314/apjcp.2015.16.2.667] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the third most common malignancy in Malaysia, where data are limited regarding knowledge and barriers in regard to CRC and screening tests. The aim of the study was to assess these parameters among Malaysians. MATERIALS AND METHODS The questionnaires were distributed in the Umra Private Hospital in Selangor. The questionnaire had four parts and covered social-demographic questions, respondent knowledge about CRC and colorectal tests, attitude towards CRC and respondentaction regarding CRC. More than half of Malay participants (total n=187) were female (57.2%) and 36.9% of them were working as professionals. RESULTS The majority of the participants (93.6%) never had a CRC screening test. The study found that only 10.2% of the study participants did not consider that their chances of getting CRC were high. A high percentage of the participants (43.3%) believed that they would have good chance of survival if the cancer would be found early. About one third of the respondents did not want to do screening because of fear of cancer, and concerns of embarrassment during the procedure adversely affected attitude to CRC screening as well. Age, gender, income, family history of CRC, vegetable intake and physical activity were found to be significant determinants of knowledge on CRC. CONCLUSIONS The major barriers identified towards CRC screening identified in our study were fear of pain and embarrassment. The findings have implications for understanding of similarities and differences in attitude to CRC amongst elderly patients in other cultural/ geographic regions.
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Affiliation(s)
- Redhwan A Al-Naggar
- Population Health and Preventive Medicine Department, Faculty of Medicine, UniversitiTeknologi MARA, Kuala Lumpur, Malaysia E-mail :
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Altobelli E, Lattanzi A, Paduano R, Varassi G, di Orio F. Colorectal cancer prevention in Europe: burden of disease and status of screening programs. Prev Med 2014; 62:132-41. [PMID: 24530610 DOI: 10.1016/j.ypmed.2014.02.010] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/26/2013] [Accepted: 02/02/2014] [Indexed: 12/12/2022]
Abstract
Colorectal cancer is a major public health challenge worldwide. In Europe it is the first malignancy in terms of incidence and the second in terms of mortality in both genders. Despite evidence indicating that removal of premalignant and early-stage cancer lesion scan greatly reduce mortality, remarkable differences are still found among countries both in terms of organized screening programs and of the tests used. In 2003 the European Council recommended that priority be given to activation of organized cancer screening programs, and various states have been making significant efforts to adopt effective prevention programs with international quality standards and centralizing screening organization and result evaluation. After a 2008 European Union report on the state of screening program, activation highlighted that little more than 50% (12/22) of Member States had colorectal cancer screening programs, Screening programs have been adopted or earlier pilot projects have been extended nationwide. This paper examines the state of activation and the screening strategies of colorectal cancer screening programs in EU States as of July 2013.
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Affiliation(s)
- E Altobelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy; Epidemiologic and Social Marketing Unit, AUSL 4 Teramo, Italy.
| | - A Lattanzi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - R Paduano
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | | | - F di Orio
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
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Gimeno Garcia AZ, Hernandez Alvarez Buylla N, Nicolas-Perez D, Quintero E. Public awareness of colorectal cancer screening: knowledge, attitudes, and interventions for increasing screening uptake. ISRN ONCOLOGY 2014; 2014:425787. [PMID: 24729896 PMCID: PMC3963118 DOI: 10.1155/2014/425787] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Accepted: 12/31/2013] [Indexed: 02/06/2023]
Abstract
Colorectal cancer ranks as one of the most incidental and death malignancies worldwide. Colorectal cancer screening has proven its benefit in terms of incidence and mortality reduction in randomized controlled trials. In fact, it has been recommended by medical organizations either in average-risk or family-risk populations. Success of a screening campaign highly depends on how compliant the target population is. Several factors influence colorectal cancer screening uptake including sociodemographics, provider and healthcare system factors, and psychosocial factors. Awareness of the target population of colorectal cancer and screening is crucial in order to increase screening participation rates. Knowledge about this disease and its prevention has been used across studies as a measurement of public awareness. Some studies found a positive relationship between knowledge about colorectal cancer, risk perception, and attitudes (perceived benefits and barriers against screening) and willingness to participate in a colorectal cancer screening campaign. The mentioned factors are modifiable and therefore susceptible of intervention. In fact, interventional studies focused on average-risk population have tried to increase colorectal cancer screening uptake by improving public knowledge and modifying attitudes. In the present paper, we reviewed the factors impacting adherence to colorectal cancer screening and interventions targeting participants for increasing screening uptake.
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Affiliation(s)
- Antonio Z Gimeno Garcia
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Unidad de Endoscopia, La Laguna, 38320 Tenerife, Spain ; Departamento de Gastroenterología, Hospital Universitario de Canarias, Unidad de Endoscopia, Ofra s/n, La Laguna, 38320 Tenerife, Spain
| | - Noemi Hernandez Alvarez Buylla
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Unidad de Endoscopia, La Laguna, 38320 Tenerife, Spain
| | - David Nicolas-Perez
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Unidad de Endoscopia, La Laguna, 38320 Tenerife, Spain
| | - Enrique Quintero
- Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Unidad de Endoscopia, La Laguna, 38320 Tenerife, Spain
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Wong MCS, Hirai HW, Luk AKC, Lam TYT, Ching JYL, Griffiths SM, Chan FKL, Sung JJY. The knowledge of colorectal cancer symptoms and risk factors among 10,078 screening participants: are high risk individuals more knowledgeable? PLoS One 2013; 8:e60366. [PMID: 23573248 PMCID: PMC3616059 DOI: 10.1371/journal.pone.0060366] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 02/25/2013] [Indexed: 12/31/2022] Open
Abstract
Objectives We tested the a priori hypothesis that self-perceived and real presences of risks for colorectal cancer (CRC) are associated with better knowledge of the symptoms and risk factors for CRC, respectively. Methods One territory-wide invitation for free CRC screening between 2008 to 2012 recruited asymptomatic screening participants aged 50–70 years in Hong Kong. They completed survey items on self-perceived and real presences of risks for CRC (advanced age, male gender, positive family history and smoking) as predictors, and knowledge of CRC symptoms and risk factors as outcome measures, respectively. Their associations were evaluated by binary logistic regression analyses. Results From 10,078 eligible participants (average age 59 years), the mean knowledge scores for symptoms and risk factors were 3.23 and 4.06, respectively (both score range 0–9). Male gender (adjusted odds ratio [AOR] = 1.34, 95% C.I. 1.20–1.50, p<0.01), self-perception as not having any risks for CRC (AOR = 1.12, 95% C.I. 1.01–1.24, p = 0.033) or uncertainty about having risks (AOR = 1.94, 95% C.I. 1.55–2.43, p<0.001), smoking (AOR 1.38, 95% C.I. 1.11–1.72, p = 0.004), and the absence of family history (AOR 0.61 to 0.78 for those with positive family history, p<0.001) were associated with poorer knowledge scores (≤4) of CRC symptoms. These factors remained significant for knowledge of risk factors. Conclusions Male and smokers were more likely to have poorer knowledge but family history of CRC was associated with better knowledge. Since screening of these higher risk individuals could lead to greater yield of colorectal neoplasm, educational interventions targeted to male smokers were recommended.
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Affiliation(s)
- Martin C. S. Wong
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hoyee W. Hirai
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Arthur K. C. Luk
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Thomas Y. T. Lam
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jessica Y. L. Ching
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sian M. Griffiths
- School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Francis K. L. Chan
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Joseph J. Y. Sung
- Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
- * E-mail:
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Ferrero Fernández IE, Echevarría Broz C, Miguel González I, Horta Valvidares M, García González JV. [Reported prevalence of family history of colorectal cancer in the city of Gijon (Spain)]. Semergen 2012; 38:498-504. [PMID: 23146702 DOI: 10.1016/j.semerg.2012.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 02/17/2012] [Accepted: 02/21/2012] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The objective of this study was to determine the prevalence of family history of colorectal cancer (CRC) in a population between 40 and 75 years-old, as well as acceptability and early diagnosis tests made. MATERIAL AND METHODS Cross-sectional study. LOCATION El Coto and El Llano (Gijon) primary care health centres. A total of 800 individuals aged between 40 and 75 years participated, selected by simple random sampling. Key measurements: questionnaire conducted by telephone with previous notice by newsletter. The variables studied were: family history (FH) of CRC, age at diagnosis, performance of faecal occult blood test (FOBT)/colonoscopy, reason for doing it or refusing it, and sociodemographic data. RESULTS A total of 664 questionnaires were valid. The prevalence of FH was 15.8% (confidence interval 12.9 to 18.6), with 8.8% with at least one first degree relative. An FOBT screening had been performed on 7.1%, and 17.9% had undergone colonoscopies, mostly on clinical grounds. Acceptability was 90.7% for FOBT and 65.2% for colonoscopy. Main reason for the refusal of an FOBT was the belief that early diagnosis would not alter prognosis. Main reason for rejection of colonoscopy was discomfort or fear of the test. CONCLUSIONS There was a low rate of testing for FH, and a high acceptability for FOBT and a low acceptability for colonoscopy. Aspects affecting the general population (causes for rejection, need for clear information), as well as a correct coordination between Primary Care, specialized care, and public health, need to be reviewed.
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Factors influencing colorectal cancer screening participation. Gastroenterol Res Pract 2011; 2012:483417. [PMID: 22190913 PMCID: PMC3235570 DOI: 10.1155/2012/483417] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 10/18/2011] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer (CRC) is a major health problem worldwide. Although population-based CRC screening is strongly recommended in average-risk population, compliance rates are still far from the desirable rates. High levels of screening uptake are necessary for the success of any screening program. Therefore, the investigation of factors influencing participation is crucial prior to design and launches a population-based organized screening campaign. Several studies have identified screening behaviour factors related to potential participants, providers, or health care system. These influencing factors can also be classified in non-modifiable (i.e., demographic factors, education, health insurance, or income) and modifiable factors (i.e., knowledge about CRC and screening, patient and provider attitudes or structural barriers for screening). Modifiable determinants are of great interest as they are plausible targets for interventions. Interventions at different levels (patient, providers or health care system) have been tested across the studies with different results. This paper analyzes factors related to CRC screening behaviour and potential interventions designed to improve screening uptake.
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Colorectal cancer screening in first-degree relatives of colorectal cancer: participation, knowledge, and barriers against screening. Eur J Gastroenterol Hepatol 2011; 23:1165-71. [PMID: 21989122 DOI: 10.1097/meg.0b013e32834a289e] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Family history is one of the most important risk factors for developing colorectal cancer (CRC), and medical organizations recommend CRC screening in this population. However, the use of CRC screening is still low in our country. OBJECTIVE To investigate the use of CRC screening, knowledge about CRC and screening tests, and factors related to screening in a family-risk population. METHODS A total of 334 family-risk participants answered a questionnaire to assess the use of CRC screening tests, knowledge about CRC, risk perception, and barriers against screening. RESULTS In total, 22% of participants had undergone at least one of the recommended tests for CRC screening. Furthermore, indication for screening was found in only 8% of participants. Use of CRC screening tests was significantly lower than mammography for breast cancer detection in women (20 vs. 82%, P<0.001) and use of serum prostate-specific antigen for prostate cancer detection in men (27 vs. 46%, P<0.001). Most participants (59%) knew that being elderly was a risk factor and only about half (47%) had knowledge about any of the recommended examinations. Only in about half of the cases (47%) was subjective risk perception higher than in the general population. In the logistic regression analysis, having more than one affected relative (odds ratio= 2.63, 95% confidence interval: 1.05-6.68; P=0.03) and a high subjective perception of risk (odds ratio= 2.87, 95% confidence interval: 1.10-7.46; P=0.03) were independent predictors for CRC screening. CONCLUSION Less than 25% of the family-risk population has undergone a CRC screening test. Family history and subjective risk perception of CRC are the strongest predictors of CRC screening.
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Gimeno-García AZ, Quintero E, Nicolás-Pérez D, Jiménez-Sosa A. Public awareness of colorectal cancer and screening in a Spanish population. Public Health 2011; 125:609-15. [PMID: 21794885 DOI: 10.1016/j.puhe.2011.03.014] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 11/16/2010] [Accepted: 03/08/2011] [Indexed: 12/16/2022]
Affiliation(s)
- A Z Gimeno-García
- Gastroenterology Department, Hospital Universitario de Canarias, Ofra s/n,38320 La Laguna, Tenerife, Spain.
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