Acceptance of preventive colonoscopy in rural areas in Germany.

Abstract

e16143 Background: Colorectal cancer is one of the most common types of cancer in Germany. Colonoscopy is certainly one of the most efficient diagnostic methods in preventing and early detection of colorectal cancer. Nevertheless, acceptance of colonoscopy as a useful screening method among the population in Germany is moderate, with around 22% of those entitled to claim. Methods: In order to better assess the reasons for the low level of acceptance, patients who presented themselves from March 2016 to June 2017 in the General Surgery Clinic of the Johanniter Hospital Stendal were randomly selected and interviewed using a questionnaire. These randomized patients did not suffer from colorectal cancer. The questionnaire asked whether the patients had participated in Colon Cancer Screening and if not for what reasons. Respondents were asked to choose among 8 preselected reasons or give their own. The options for not having participated in colorectal cancer screening were: lack of knowledge about the offer of colorectal cancer screening, fear of the examination, fear of cancer as an outcome, lack of time for the examination, didn't get an appointment for the exam, place of examination is too far away, excessive travel costs, examination makes no sense, and other (free text entry). Results: A total of 238 questionnaires were completed, 235 of which could be evaluated with regard to gender and age. The proportion between women and men was balanced (m 123, w 112). Surprisingly, contrary to expectations, significantly more respondents participated in colorectal cancer screening than not. There were no differences between females and males. The participation rate in colorectal cancer screening was 71%, which was significantly higher than expected. A significantly lower rate was found in respondents ages between 55 to 60 years old, with 41% of men and 67% of women having participated in a colorectal screening. Asked specifically about the reasons why they did not take advantage of the preventive medical check-up, the men of the affected age group (55-60 years) gave: fear of the examination, fear of cancer as an outcome, and examination makes no sense. Conclusions: The results underline the importance of determining why the acceptance of colorectal cancer screening has not yet reached the desired level. Considering and discussing these three main reasons show that there are opportunities to continuously increase awareness of the importance of participation rates in colonoscopy as a screening method for colorectal cancer through target public education.