Factors Affecting Participation in the Colorectal Cancer Screening Program: a Cross-sectional Population Study

Overview

Journal J Cancer Res Clin Oncol

Specialty Oncology

Date 2023 Jun 22

PMID 37347259

Authors

Alexandra Romanova

Michala Lustigova

Jana Urbanova

Radan Keil

Pavlina Krollova

Jan Stovicek

Martin Wasserbauer

Stepan Hlava

Jana Malinovska

Jiri Drabek

Jan Broz

Affiliations

Soon will be listed here.

Abstract

Purpose: Fecal immunochemical test (FIT) once a year or colonoscopy once in 10 years is the option approved for colorectal cancer (CRC) screening for asymptomatic individuals aged ≥ 50 years in the Czech Republic. We analyzed participation in the screening program to determine possible improvements.

Methods: In this observational cross-sectional study, data were collected from 4044 randomly chosen individuals from the Czech population (1866 men, 2178 women) aged ≥ 50 years by questionnaires. Individuals who underwent colonoscopy within the last 10 years or/and FIT within the last 2 years were classified as participants in the screening.

Results: 1050 individuals underwent FIT, 464 colonoscopy, and 558 underwent both. Adjusted for age, gender, and education, a higher chance of participation in the screening was observed in groups of non-smokers (OR = 1.25; CI 1.05-1.48), ex-smokers (OR = 1.51; CI 1.26-1.83), consuming smoked meat products less than once a week (OR = 1.26; CI 1.09-1.45), practicing physical activity at least once a week (OR = 1.25; CI 1.03-1.51), hospitalized in the past 12 months (OR = 1.73; CI 1.47-2.05), or consulting a general practitioner (GP) in the past 12 months (OR = 2.26; CI 1.87-2.74). The chance of participation of individuals having a risk factor for CRC (obesity, smoking, diabetes, low physical activity, alcohol drinking) was not higher compared to those without the risk factors.

Conclusion: Individuals with a tendency to a healthy lifestyle or being in recent contact with the healthcare system by various means, mainly visiting a GP, had a higher participation in the screening for CRC. Among groups with an increased risk for CRC, higher participation was not shown.

References

Botteri E, Iodice S, Bagnardi V, Raimondi S, Lowenfels A, Maisonneuve P . Smoking and colorectal cancer: a meta-analysis. JAMA. 2008; 300(23):2765-78. DOI: 10.1001/jama.2008.839. View

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Jantti M, Heinavaara S, Malila N, Sarkeala T . Sociodemographic features and patterns of non-participation in colorectal cancer screening in Finland. Eur J Public Health. 2021; 31(4):890-894. DOI: 10.1093/eurpub/ckab074. View

He J, Stram D, Kolonel L, Henderson B, Le Marchand L, Haiman C . The association of diabetes with colorectal cancer risk: the Multiethnic Cohort. Br J Cancer. 2010; 103(1):120-6. PMC: 2905298. DOI: 10.1038/sj.bjc.6605721. View

Boyle T, Keegel T, Bull F, Heyworth J, Fritschi L . Physical activity and risks of proximal and distal colon cancers: a systematic review and meta-analysis. J Natl Cancer Inst. 2012; 104(20):1548-61. DOI: 10.1093/jnci/djs354. View

Chen H, Li N, Ren J, Feng X, Lyu Z, Wei L . Participation and yield of a population-based colorectal cancer screening programme in China. Gut. 2018; 68(8):1450-1457. DOI: 10.1136/gutjnl-2018-317124. View

Gruner L, Amitay E, Heisser T, Guo F, Niedermaier T, Gies A . The Effects of Different Invitation Schemes on the Use of Fecal Occult Blood Tests for Colorectal Cancer Screening: Systematic Review of Randomized Controlled Trials. Cancers (Basel). 2021; 13(7). PMC: 8037417. DOI: 10.3390/cancers13071520. View

Unanue-Arza S, Solis-Ibinagagoitia M, Diaz-Seoane M, Mosquera-Metcalfe I, Idigoras I, Bilbao I . Inequalities and risk factors related to non-participation in colorectal cancer screening programmes: a systematic review. Eur J Public Health. 2020; 31(2):346-355. PMC: 8071594. DOI: 10.1093/eurpub/ckaa203. View

McNabb S, Harrison T, Albanes D, Berndt S, Brenner H, Caan B . Meta-analysis of 16 studies of the association of alcohol with colorectal cancer. Int J Cancer. 2019; 146(3):861-873. PMC: 6819207. DOI: 10.1002/ijc.32377. View

10.

Selva A, Tora N, Pascual E, Espinas J, Bare M . Effectiveness of a brief phone intervention to increase participation in a population-based colorectal cancer screening programme: a randomized controlled trial. Colorectal Dis. 2019; 21(10):1120-1129. DOI: 10.1111/codi.14707. View

11.

Levin T, Corley D, Jensen C, Schottinger J, Quinn V, Zauber A . Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large Community-Based Population. Gastroenterology. 2018; 155(5):1383-1391.e5. PMC: 6240353. DOI: 10.1053/j.gastro.2018.07.017. View

12.

Mahmood S, MacInnis R, English D, Karahalios A, Lynch B . Domain-specific physical activity and sedentary behaviour in relation to colon and rectal cancer risk: a systematic review and meta-analysis. Int J Epidemiol. 2017; 46(6):1797-1813. DOI: 10.1093/ije/dyx137. View

13.

Bozhar H, McKee M, Spadea T, Veerus P, Heinavaara S, Anttila A . Socio-economic inequality of utilization of cancer testing in Europe: A cross-sectional study. Prev Med Rep. 2022; 26:101733. PMC: 8850331. DOI: 10.1016/j.pmedr.2022.101733. View

14.

Ma Y, Yang Y, Wang F, Zhang P, Shi C, Zou Y . Obesity and risk of colorectal cancer: a systematic review of prospective studies. PLoS One. 2013; 8(1):e53916. PMC: 3547959. DOI: 10.1371/journal.pone.0053916. View

15.

Farvid M, Sidahmed E, Spence N, Mante Angua K, Rosner B, Barnett J . Consumption of red meat and processed meat and cancer incidence: a systematic review and meta-analysis of prospective studies. Eur J Epidemiol. 2021; 36(9):937-951. DOI: 10.1007/s10654-021-00741-9. View