Observational Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2019; 25(9): 1132-1141
Published online Mar 7, 2019. doi: 10.3748/wjg.v25.i9.1132
Viewpoints of the target population regarding barriers and facilitators of colorectal cancer screening in the Czech Republic
Radek Kroupa, Monika Ondrackova, Petra Kovalcikova, Milan Dastych, Tomas Pavlik, Lumir Kunovsky, Jiri Dolina
Radek Kroupa, Milan Dastych, Lumir Kunovsky, Jiri Dolina, Department of Gastroenterology and Internal Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno 62500, Czech Republic
Monika Ondrackova, Department of Hematology, Oncology and Internal Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno 62500, Czech Republic
Petra Kovalcikova, Tomas Pavlik, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno 62500, Czech Republic
Author contributions: Kroupa R, Ondrackova M and Pavlik T designed the research study; Kroupa R and Ondrackova M performed the research; Kovalcikova P and Pavlik T analyzed data and reviewed statistics; Kroupa R wrote the manuscript; Kunovsky L, Dastych M and Dolina J revised the paper; all authors have read and approve the final manuscript.
Supported by the project (Ministry of Health, Czech Republic) for Conceptual Development of Research Organization 65269705 (University Hospital Brno, Czech Republic).
Institutional review board statement: The study was reviewed and approved by the Ethical Board of University Hospital Brno.
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None declared.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement - checklist of items, and the manuscript was prepared and revised according to the STROBE Statement - checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Radek Kroupa, MD, PhD, Research Assistant Professor, Department of Gastroenterology and Internal Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Jihlavska 20, Brno 62500, Czech Republic. kroupa.radek@fnbrno.cz
Telephone: +420-532233500
Received: October 23, 2018
Peer-review started: October 23, 2018
First decision: November 29, 2019
Revised: January 12, 2019
Accepted: January 28, 2019
Article in press: January 28, 2019
Published online: March 7, 2019
Abstract
BACKGROUND

Public awareness of colorectal cancer (CRC) and uptake of CRC screening remain challenges. The viewpoints of the target population (asymptomatic individuals older than 50) regarding CRC screening information sources and the reasons for and against participation in CRC screening are not well known in the Czech Republic. This study aimed to acquire independent opinions from the target population independently on the health system.

AIM

To investigate the viewpoints of the target population regarding the source of information for and barriers and facilitators of CRC screening.

METHODS

A survey among relatives (aged 50 and older) of university students was conducted. Participants answered a questionnaire about sources of awareness regarding CRC screening, reasons for and against participation, and suggestions for improvements in CRC screening. The effect of certain variables on participation in CRC screening was analyzed.

RESULTS

Of 498 participants, 478 (96%) respondents had some information about CRC screening and 375 (75.3%) had participated in a CRC screening test. General practitioners (GPs) (n = 319, 64.1%) and traditional media (n = 166, 33.3%) were the most common information sources regarding CRC screening. A lack of interest or time and a fear of colonoscopy or positive results were reported as reasons for non-participation. Individuals aged > 60 years [adjusted odds ratio (aOR) = 2.30, 95% confidence interval (CI) (1.42-3.71), P = 0.001], females (aOR = 1.95, 95%CI (1.26-3.01) P = 0.003), and relatives of CRC patients (aOR = 4.17, 95%CI (1.82-9.58) P = 0.001) were more likely to participate in screening. Information regarding screening provided by physicians - GPs: (aOR = 8.11, 95%CI (4.90-13.41), P < 0.001) and other specialists (aOR = 4.19, 95%CI (1.87-9.38), P = 0.001) increased participation in screening. Respondents suggested that providing better explanations regarding screening procedures and equipment for stool capturing could improve CRC screening uptake.

CONCLUSION

GPs and other specialists play crucial roles in the successful uptake of CRC screening. Reduction of the fear of colonoscopy and simple equipment for stool sampling might assist in improving the uptake of CRC screening.

Keywords: Colorectal cancer, Screening, Colonoscopy, General practitioner, Patient compliance, Fecal occult blood test

Core tip: The attitudes of the target population regarding colorectal cancer (CRC) screening program and its components - fecal occult blood test and colonoscopy were surveyed among 498 participants in the first study ever conducted in the Czech Republic. A lack of interest or time and a fear of colonoscopy or positive results were reported as reasons for non-participation. We found that general practitioners and other specialists play an imperative role in the uptake of CRC screening with odds ratio 8.11 and odds ratio 4.19 respectively. Reduction of the fear of colonoscopy, routine use of analgosedation, and simple equipment for stool sampling might assist in improving the uptake of CRC screening.