Comparing Different Strategies for Colorectal Cancer Screening in Italy: Predictors of Patients’ Participation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-10-13

AUTHORS

Carlo Senore, Paola Armaroli, Marco Silvani, Bruno Andreoni, Luigi Bisanti, Luisa Marai, Guido Castiglione, Grazia Grazzini, Serena Taddei, Stefano Gasperoni, Orietta Giuliani, Giuseppe Malfitana, Anna Marutti, Giovanna Genta, Nereo Segnan

ABSTRACT

OBJECTIVES: The objective of this study was to study predictors of patients' participation in colorectal cancer (CRC) screening. METHODS: Men and women, aged 55-64 years, were randomized to the following: (i) biennial fecal occult blood test (FOBT) delivered by mail (n=2,266); (ii) FOBT delivered by a general practitioner (GP)/screening facility (n=5,893); (iii) "once-only" sigmoidoscopy (FS) (n=3,650); (iv) FS followed by FOBT for screenees with negative FS (n=10,867); and (v) patient's choice between FS and FOBT (n=3,579). A stratified (by screening arm) random sample of attenders and nonattenders was contacted by trained interviewers 4 months after the initial invitation. Subjects giving their consent were administered a questionnaire (available online) investigating perceptions of individual CRC risk, attitudes toward prevention, adoption of health protective behaviors, and reasons for attendance/nonattendance. Adjusted prevalence odds ratios (ORs) were computed by multivariable logistic regression. RESULTS: The response rate was 71.9% (701 of 975) among nonattenders and 88.9% (773 of 870) among attenders. Adjusting for screening arm, center, gender, age, and education, participation was significantly higher among people who consulted their GP before undergoing screening (OR: 4.24; 95% confidence interval (CI): 3.11-5.78), who mentioned one first-degree relative with CRC (OR: 3.62; 95% CI: 2.02-6.49), who reported regular physical activity (OR: 1.85; 95% CI: 1.33-2.55), and who read the mailed information (letter only: OR: 1.85; 95% CI: 1.23-2.78; letter+leaflet: OR: 3.18; 95% CI: 2.12-4.76). People who considered screening to be ineffective (OR: 0.12; 95% CI: 0.08-0.19), those who considered it to be effective but reported even moderate levels of anxiety (OR: 0.32; 95% CI: 0.23-0.45), and those who mentioned previous knowledge of CRC screening tests were less likely to accept the invitation (OR: 0.49; 95% CI: 0.34-0.70). CONCLUSIONS: Adoption of health protective behaviors is associated with a higher attendance rate, whereas anxiety represents a strong barrier, even among people who deemed screening to be effective. Increasing the proportion of people who consult their GP when making a decision regarding screening might enhance participation. More... »

PAGES

188

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/ajg.2009.583

DOI

http://dx.doi.org/10.1038/ajg.2009.583

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1014635914

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/19826409


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25 schema:description OBJECTIVES: The objective of this study was to study predictors of patients' participation in colorectal cancer (CRC) screening. METHODS: Men and women, aged 55-64 years, were randomized to the following: (i) biennial fecal occult blood test (FOBT) delivered by mail (n=2,266); (ii) FOBT delivered by a general practitioner (GP)/screening facility (n=5,893); (iii) "once-only" sigmoidoscopy (FS) (n=3,650); (iv) FS followed by FOBT for screenees with negative FS (n=10,867); and (v) patient's choice between FS and FOBT (n=3,579). A stratified (by screening arm) random sample of attenders and nonattenders was contacted by trained interviewers 4 months after the initial invitation. Subjects giving their consent were administered a questionnaire (available online) investigating perceptions of individual CRC risk, attitudes toward prevention, adoption of health protective behaviors, and reasons for attendance/nonattendance. Adjusted prevalence odds ratios (ORs) were computed by multivariable logistic regression. RESULTS: The response rate was 71.9% (701 of 975) among nonattenders and 88.9% (773 of 870) among attenders. Adjusting for screening arm, center, gender, age, and education, participation was significantly higher among people who consulted their GP before undergoing screening (OR: 4.24; 95% confidence interval (CI): 3.11-5.78), who mentioned one first-degree relative with CRC (OR: 3.62; 95% CI: 2.02-6.49), who reported regular physical activity (OR: 1.85; 95% CI: 1.33-2.55), and who read the mailed information (letter only: OR: 1.85; 95% CI: 1.23-2.78; letter+leaflet: OR: 3.18; 95% CI: 2.12-4.76). People who considered screening to be ineffective (OR: 0.12; 95% CI: 0.08-0.19), those who considered it to be effective but reported even moderate levels of anxiety (OR: 0.32; 95% CI: 0.23-0.45), and those who mentioned previous knowledge of CRC screening tests were less likely to accept the invitation (OR: 0.49; 95% CI: 0.34-0.70). CONCLUSIONS: Adoption of health protective behaviors is associated with a higher attendance rate, whereas anxiety represents a strong barrier, even among people who deemed screening to be effective. Increasing the proportion of people who consult their GP when making a decision regarding screening might enhance participation.
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36 Italy
37 activity
38 adjusted prevalence odds ratios
39 adoption
40 age
41 anxiety
42 arm
43 attendance rates
44 attenders
45 attitudes
46 barriers
47 behavior
48 biennial faecal occult blood test
49 blood tests
50 cancer screening
51 center
52 choice
53 colorectal cancer screening
54 consent
55 decisions
56 different strategies
57 education
58 facilities
59 fecal occult blood test
60 first-degree relatives
61 gender
62 general practitioners
63 health-protective behaviors
64 high attendance rate
65 individual’s CRC risk
66 information
67 initial invitation
68 invitation
69 knowledge
70 levels
71 logistic regression
72 mail
73 men
74 moderate levels
75 months
76 multivariable logistic regression
77 negative FS
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79 nonattenders
80 objective
81 occult blood test
82 odds ratio
83 participation
84 patient choice
85 patient participation
86 patients
87 people
88 perception
89 physical activity
90 practitioners
91 predictors
92 predictors of patients
93 prevalence odds ratios
94 prevention
95 previous knowledge
96 proportion
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