Influencing Cancer Screening Participation Rates—Providing a Combined Cancer Screening Program (a ‘One Stop’ Shop) Could Be a Potential Answer

Abstract

IntroductionParticipation in established cancer screening programs remains variable. Therefore, a renewed focus on how to increase screening uptake, including addressing structural barriers such as time, travel, and cost is needed. One approach could be the provision of combined cancer screening, where multiple screening tests are provided at the same time and location (essentially a ‘One Stop’ screening shop). This cohort study explored both cancer screening behavior and the acceptability of a combined screening approach.MethodsParticipants of the North Western Adelaide Health Study (NWAHS), South Australia were invited to participate in a questionnaire about cancer screening behaviors and the acceptability of a proposed ‘One Stop’ cancer screening shop. Data were collected from 10th August 2015 to 18th January 2016, weighted for selection probability, age, and sex and analyzed using descriptive and multivariable logistic regression analysis.Results1,562 people, 52% female (mean age 54.1 years ± 15.2) participated. Reported screening participation was low, the highest being for Pap Smear (34.4%). Common reasons for screening participation were preventing sickness (56.1%, CI 53.2–59.0%), maintaining health (51%, CI 48–53.9%), and free program provision (30.9%, CI 28.2–33.6%). Females were less likely to state that screening is not beneficial [OR 0.37 (CI 0.21–0.66), p < 0.001] and to cite sickness prevention [OR 2.10 (CI 1.46–3.00), p < 0.001] and free program [OR 1.75 (CI 1.22–2.51), p < 0.003] as reasons for screening participation. Of those who did not participate, 34.6% (CI 30.3–39.1%) stated that there was nothing that discouraged them from participation, with 55- to 64-year olds [OR 0.24 (CI 0.07–0.74), p < 0.04] being less likely to cite this reason. 21% (CI 17.2–24.8%) thought they did not need screening, while a smaller proportion stated not having time (6.9%, CI 4.9–9.7%) and the costs associated with screening (5.2%, CI 3.5–7.7%). The majority of participants (85.3%, CI 81.9–88.2%) supported multiple screening being offered at the same time and location.ConclusionIdentified screening behaviors in this study are similar to those reported in the literature. The high support for the concept of combined cancer screening demonstrates that this type of approach is acceptable to potential end users and warrants further investigation.

The impact of socioeconomic deprivation on the uptake of colorectal cancer screening in London

“…The idea of a 'one stop' clinic, similar to breast cancer screening, which would offer multiple screening tests at the same time and location to improve participation amongst patients, has been proposed. 39 Although acceptable to patients, the influence such a clinic would have on enhancing CRC screening participation overall and in terms of socioeconomic deprivation is currently unclear. 40 Even changing the investigation of choice for screening has been looked at as an avenue to improve uptake rates.…”

Comparative analysis of the access to health-care services and breast cancer therapy in 10 Eastern European countries

“…Treatment guidance could be influenced by country's specific cancer outcome indicators such as incidence; mortality and survival; access to health-care services including screening, treatment and care, and benefit/cost or cost/ effectiveness ratios; restricted health-care resource utilization; and budget constraints. [8][9][10] A report of the European Commission concerning the challenges of cancer shows that some of the main reasons for these inequalities, especially in the Eastern European countries, could be attributed to differences in the lifestyles, socioeconomic status, different level of implemented preventive actions, the organization of screening programs, and the infrastructure and distribution of health-care facilities. 11 Important limitations and differences among Central and Eastern European (CEE) patients are also observed in terms of availability and costs of new medicines and drug shortages for medicines with well-established use, included in the list of "essential" medicines.…”

Patient perspectives on colorectal cancer screening and the role of general practice

“…Positive attitudes and prior screening experience have consistently emerged as enabling factors. The latter may refer to FOBT experience, with Australian re-participation rates over 70% [3], with higher re-participation rates believed to be due to familiarity with screening culture and regularly participating in breast/cervical screening [9]. In addition, individuals with higher education, health motivation, and personal or familial cancer experience are more likely to participate.…”