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
Processing time: 135 Days and 7.4 Hours
ARTICLE HIGHLIGHTS
Research background

The Czech Republic is one of the countries with the highest incidence rates of colorectal cancer (CRC) worldwide. The actual participation of asymptomatic individuals in screening procedures (approximately 30% in 2016) is still far from the desired rate. Public awareness of CRC and uptake of CRC screening remain challenges.

Research motivation

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. Tailored screening support and promotion may increase participation rates and efficacy of screening program.

Research objectives

This study aimed to acquire independent opinions from the target population regarding CRC screening information sources and the reasons for and against participation in CRC screening, independently on the health system.

Research 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.

Research results

The majority of respondents had some information about CRC screening. General practitioners (GPs) (64.1%) and traditional media (33.3%) were the most common information sources regarding CRC screening. Only 24.7% respondents had never participated in a 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, females and relatives of CRC patients were more likely to participate in screening. Information regarding screening provided by physicians - GPs and other specialists increased participation in screening importantly. Respondents suggested that providing better explanations regarding screening procedures and equipment for stool capturing could improve CRC screening uptake.

Research conclusions

GPs and other specialists play a crucial role in improving the uptake of CRC screening, while other educational tools were less effective. Reduction of the fears of colonoscopy by focused campaigns, routine use of analgosedation, and better equipment for stool sampling might encourage the target population to participate in screenings.

Research perspectives

In the future, regular surveys of the target populations’ attitude toward CRC screening may gain interesting facts for further improvement of the screening program. Focus on the role of physician’s advice for the screening participation and better communication during routine health consultation regarding the results of screening tests and related benefits could increase participation rates.