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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33 CRC risk
34 CRC screening tests
35 FS
36 Italy
37 activity
38 adjusted prevalence odds ratios
39 adoption
40 age
41 anxiety
42 arm
43 attendance rates
44 attendance/nonattendance
45 attenders
46 attitudes
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48 behavior
49 biennial faecal occult blood test
50 blood tests
51 cancer screening
52 center
53 choice
54 colorectal cancer screening
55 consent
56 decisions
57 different strategies
58 education
59 facilities
60 fecal occult blood test
61 first-degree relatives
62 gender
63 general practitioners
64 health protective behaviors
65 high attendance rate
66 individual's CRC risk
67 information
68 initial invitation
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70 invitation
71 knowledge
72 levels
73 logistic regression
74 mail
75 men
76 moderate levels
77 months
78 multivariable logistic regression
79 negative FS
80 nonattendance
81 nonattenders
82 objective
83 occult blood test
84 odds ratio
85 participation
86 patient choice
87 patient participation
88 patients
89 people
90 perception
91 physical activity
92 practitioners
93 predictors
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95 prevalence odds ratios
96 prevention
97 previous knowledge
98 proportion
99 proportion of people
100 protective behaviors
101 questionnaire
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