Adherence to and predictors of participation in colorectal cancer screening with faecal occult blood testing in Spain, 2009–2011

Abstract

The aim of the study was to describe the adherence to faecal occult blood test (FOBT) screening in Spain during the period 2009-2011 and analyse possible associated factors. This study was cross-sectional in design and used data from the European Health Survey 2009 and the Spanish National Health Survey 2011, which were conducted through home interviews with a representative sample of the Spanish population. Adherence to screening was analysed by asking participants aged 50-69 years whether they had undergone a FOBT in the last 2 years. Independent variables included sociodemographic characteristics and variables related to health status and lifestyle. In 2009, 4.23% [95% confidence interval (CI) 3.65-4.81] of the Spanish population aged 50-69 years had undergone a FOBT over the previous 2 years. In 2011, an increase to 7.74% (95% CI 6.94-8.47; P<0.01) was observed. Men had greater adherence to the FOBT compared with women. Individuals living in regions with a population-based screening programme proved to have a greater probability of undergoing this test. In 2011, this probability was 2.99 times greater (95% CI 2.38-3.76). Factors such as suffering from chronic diseases, frequent visits to doctors or having a health status perceived as poor were positive predictive factors for adherence. Adherence to screening has not yet been firmly established, and participation figures remain very low. It is necessary to develop promotional and educational programmes to improve adherence to FOBT screening in Spain.