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Bispebjerg Hospital - a part of Copenhagen University Hospital
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Factors affecting patient adherence to publicly funded colorectal cancer screening programmes: a systematic review

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OBJECTIVES: Colorectal cancer (CRC) is the third most common cancer. Many countries in Europe have already implemented systematic screening programmes as per the recommendations by the European Union. The impact of screening is highly dependent on participation rates. The aim of the study was to identify barriers, facilitators and modifiers to participation in systematised, stool sample-based, publicly financed CRC screening programmes.

STUDY DESIGN: Systematic review.

METHODS: A systematic search in PubMed, Embase, MEDLINE, CINAHL, Cochrane CENTRAL, Google Scholar and PsycINFO was undertaken. We included both qualitative and quantitative studies reporting on barriers and facilitators (excluding sociodemographic variables) to participation in stool sample-based CRC screening. Barriers and facilitators to participation were summarised and analysed.

RESULTS: The inclusion criteria were met in 21 studies. Reported barriers and facilitators were categorised into the following seven themes (examples): psychology (fear of cancer), religion (believing cancer is the will of God), logistics (not knowing how to conduct the test), health-related factors (mental health), knowledge and awareness (lack of knowledge about the test), role of the general practitioner (being supported in taking the test by the general practitioner), and environmental factors (knowing someone who has participated in a screening programme). Six studies reported that non-participation was not due to a negative attitude towards screening for CRC.

CONCLUSION: Many barriers to screening were found. It is important to work with peoples' fear of screening. Moreover, this review suggests that it might be possible to increase participation rates, if the population-wide awareness and knowledge of potential health benefits of CRC screening are increased and proper logistical support is provided.

Original languageEnglish
JournalJournal of Public Health
Volume190
Pages (from-to)67-74
Number of pages8
ISSN1741-3842
DOIs
Publication statusPublished - Jan 2021

Bibliographical note

Publisher Copyright:
© 2020 The Royal Society for Public Health

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

    Research areas

  • Barriers, Colorectal cancer, Mixed methods, Review, Screening, Stool sample, Patient Participation/psychology, Attitude to Health, Humans, Social Support, Male, Mental Health, Health Knowledge, Attitudes, Practice, Practice Patterns, Physicians', Colorectal Neoplasms/diagnosis, Fear, Patient Compliance/psychology, Patient Acceptance of Health Care, Health Services Accessibility, Mass Screening/psychology, Early Detection of Cancer/psychology, Female, Intention

ID: 61654179