Original articlePerceived barriers and benefits in the participation in faecal occult blood test colorectal cancer screening programmeBarreras y beneficios percibidos en la participación en el cribado de cáncer de colon mediante test de sangre oculta en heces
Section snippets
Background
Colorectal cancer (CRC) is the second most common cause of cancer-related deaths in the world, accounting 935.173 deaths in 2020. The incidence of this neoplasm, irrespective of gender, is the third highest after breast and lung cancer, with an estimated 1.931.590 new cases in 2020.1
Five-year relative survival rate for patients with CRC in Spain is just 57%. Survival of CRC patients detected in a screening programme is higher than that of patients diagnosed for symptoms.2 The screening strategy
Methods
We designed a case–control study performed in three primary health centres in Valencia, Spain: Chile, Argentina and Serrería II. We performed a simple random sampling among individuals invited to participate in the colorectal cancer screening programme. Data were collected by previously trained researchers from March to September 2019. The individuals agreeing to participate in the study were scheduled for an in-person appointment on the invitation of the researchers.
We included subjects
Results
A total of 1017 individuals were invited to participate in the study. As shown in Fig. 2, 358 individuals could not be contacted; 128 did not want to participate; 80 were unable to attend the interviews; and 43 did not meet the criteria for inclusion.
Out of 408 individuals included, 237 participated in the screening programme (cases) and 171 did not participate (controls). No statistically significant differences were found between the individuals included/excluded with regard to age and
Discussion
Our study found that the theoretical HBM model is consistent with CRC screening in the Spanish population. The perceived barriers stated by individuals with regard to the collection of FOBT samples appear as the most powerful cognitive concept of the Model, unlike the benefits of the screening. This has to be taken into account when planning educational interventions in the population.
Mean age of participants was around 60 years, in line with the age of similar studies, as it is the usual age
Conclusions
As a conclusion, we can say that the existing barriers for screening with FOBT are the factor best predicting participation in CRC screening programmes. This is significant when designing the intervention programmes, as they should focus on reducing perceived barriers and improving accessibility to the test to increase the participation in CRC screening, thereby reducing CRC mortality. Longitudinal studies in different populations are necessary to make further progress in the understanding of
Ethics approval
The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of the General Directorate for Public Health and Higher Centre for Public Health Research of Valencia (protocol code 20190301/04 and date of approval 01/03/2019).
Funding
This work received funding from the Spanish Society of Family and Community Medicine – semFYC – by being the winner of a grant for the completion of doctoral theses Isabel Fernández 2021.
Conflict of interest
The authors declare no conflicts of interest.
Acknowledgements
To all my promotion colleagues, tutors, and especially my father for his unconditional support. To semFYC for financing this project with one of its grants.
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