Abstract
BackgroundThe major limit to colorectal cancer screening effectiveness is often low compliance. We studied the reasons for non compliance and determinants of compliance to faecal occult blood tests in Lazio, Italy.MethodsThis is a case-control study nested within a trial that tested the effect of type of test and provider on colorectal cancer screening compliance. Non compliant trial subjects were classified as cases, and compliant subjects were classified as controls. We sampled 600 cases and 600 controls matched by their general practitioner, half were invited for screening at the hospital, and the other half directly at their general practitioner's office. Cases and controls answered questions on: distance from test provider, logistical problems, perception of colorectal cancer risk, confidence in screening efficacy, fear of results, presence of colorectal cancer in the family, and gastrointestinal symptoms.ResultsAbout 31% of cases never received the letter offering free screening, and 17% of the sampled population had already been screened. The first reported reason for non-compliance was "lack of time" (30%); the major determinant of compliance was the distance from the test provider: odds ratio >30 minutes vs <15 minutes 0.3 (95%CI = 0.2–0.7). The odds ratio for lack of time was 0.16 (95% IC 0.1–0.26). The effect was stronger if the hospital (0.03 95%CI = 0.01–0.1) rather than the general practitioner (0.3 95%CI = 0.2–0.6) was the provider. Twenty-two percent of controls were accompanied by someone to the test.ConclusionTo increase compliance, screening programmes must involve test providers who are geographically close to the target population.
Highlights
The major limit to colorectal cancer screening effectiveness is often low compliance
The efficacy of colorectal cancer screening (CRCS) using faecal occult blood tests (FOBT) in reducing colorectal cancer (CRC) mortality in the 50–75 year old population has been demonstrated in large randomised trials[1]
The already-reached Fifty-four non compliant people declared that they had already been screened, 20 by FOBT in the previous two years, 38 by colonoscopy in the previous 10 years and 21 by double contrast barium enema (DCBE) in the previous 10 years
Summary
The major limit to colorectal cancer screening effectiveness is often low compliance. We studied the reasons for non compliance and determinants of compliance to faecal occult blood tests in Lazio, Italy. The efficacy of colorectal cancer screening (CRCS) using faecal occult blood tests (FOBT) in reducing colorectal cancer (CRC) mortality in the 50–75 year old population has been demonstrated in large randomised trials[1]. The reduction in mortality by screening is strictly linked to its ability to involve as many people among the target population as possible. Sampling of target population 2/10 = 3604. 64 Sampling of taqragrgetet population 2/10 = 3716 1 withdrawal
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have