Colorectal Cancer Screening: Have We Addressed Concerns and Needs of the Target Population?

Abstract

Despite the recognized benefits of colorectal cancer (CRC) screening, uptake is still suboptimal in many countries. In addressing this issue, one important element that has not received sufficient attention is population preference. Our review provides a comprehensive summary of the up-to-date evidence relative to this topic. Four OVID databases were searched: Ovid MEDLINE® ALL, Biological Abstracts, CAB Abstracts, and Global Health. Among the 742 articles generated, 154 full texts were selected for a more thorough evaluation based on predefined inclusion criteria. Finally, 83 studies were included in our review. The general population preferred either colonoscopy as the most accurate test, or fecal occult blood test (FOBT) as the least invasive for CRC screening. The emerging blood test (SEPT9) and capsule colonoscopy (nanopill), with the potential to overcome the pitfalls of the available techniques, were also favored. Gender, age, race, screening experience, education and beliefs, the perceived risk of CRC, insurance, and health status influence one’s test preference. To improve uptake, CRC screening programs should consider offering test alternatives and tailoring the content and delivery of screening information to the public’s preferences. Other logistical measures in terms of the types of bowel preparation, gender of endoscopist, stool collection device, and reward for participants can also be useful.

Differences and Similarities in Breast and Colorectal Cancer Screening Uptake among Municipalities in Flanders, Belgium

“…These evidences point to the need for effective interventions aimed at reducing disparities and improving access to care among more vulnerable individuals. In this regard, healthcare providers have both the power and responsibility to guide patients' decision-making processes and positively influence screening participation [32,33]. In accordance with a previous study on CRC conducted in Flanders [17] we have found that a higher percentage of people with at least one general practitioner (GP) visit in the previous year is associated with higher uptake of both CRC and BC screening.…”

“…Higher education (as a proxy for education level and health literacy) may facilitate comprehension of screening information and, therefore, adhesion to preventive behaviors [27]. Moreover, with regard to FOBT screening, higher health literacy may help overcome psychological barriers related to stool collection [17,32]. Residential stability (same address), on the other hand, guarantees that invitation letters arrive at the correct address.…”

State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain

“…Continuous research efforts are targeting a wider uptake of the CRC screening [ 5 ] through finding alternative, currently accepted, non-invasive screening methods [ 6 ] because CRC is still accountable for half of the cancer-related deaths worldwide [ 7 ]. Colonoscopy is both an exploratory and interventional procedure.…”

Differences and Similarities in Breast and Colorectal Cancer Screening Uptake Among Municipalities in Flanders, Belgium

“…Moreover, people who see their GP more regularly may overestimate their health status, feel "safer" and not feel the need to participate in screening. Nevertheless, literature shows that suggestions by one's GP may play an important role in positively influencing screening participation [33].…”

“…Higher education (as a proxy for education level and health literacy) may facilitate comprehension of screening information and therefore adhesion to preventive behaviors [27]. Moreover, with regards to FOBT screening, a higher health literacy may help overcome psychological barriers related to stool collection [17], [33]. Residential stability (same address), on the other hand, guarantees that invitation letters arrive at the right address.…”