Identifying the main barriers for participation in a population-based colorectal cancer screening programme in East Azerbaijan, Iran

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of death worldwide. However, CRC is considered as one of the most preventable cancers by which the mortality rates reduce about 60% through implementing the screening programmes. The present study aimed to evaluate the main barriers of CRC screening in a defined population. Method:Healthy individuals from all regions of the state were invited to participate in different healthcare centres. They were assessed by a provided online risk assessment tool, which was completed for all recruited subjects, and has been developed to assess the CRC risk based on personal and family history of adenoma, CRC, and other high-risk diseases. Research team staff assessed all individuals by this tool and then eligible people according to their lifetime risk of CRC were included in the study. There was not any age restriction in this study. Colonoscopy and three stool-based tests including faecal occult blood test, faecal immunochemical test and stool DNA tests were performed.Results: Overall, 725 cases including 425 (58.6%) males and 300 (41.4%) females participated in the study. Lack of knowledge and attitude about screening programmes was the most common barrier, especially among women (68% for women versus 58% for men) and those from rural areas (88% in rural versus 55% in urban areas). Fear of colonoscopy and procedure complications and pain (48%), discomfort and anxiety from inserting a tube into the bowel (65% among females versus 43% among males) were reported commonly. Embarrassment and dignity were other complaints, especially in women (62% in females versus 35% in males).

Socioeconomic differences in discrepancies between expected and experienced discomfort from colonoscopy and colon capsule endoscopy

“…It has proven difficult to reduce inequalities between socioeconomic subgroups as most interventions targeted at the entire population, are less efficient in the less privileged subgroups [ [12] , [13] , [14] , [15] , [16] , [17] , [18] ]. Previous research have identified barriers to screening participation such as perceived risk of disease, fear of the result, the faecal collection, expected discomfort, and invasiveness of the procedures [ [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] ]. These barriers are very unlikely to be of equal relevance to all individuals.…”