Factors influencing participation in colorectal cancer screening programs in Spain

• Published in: Preventive medicine Vol. 105; pp. 190 - 196
• Main Authors: Vanaclocha-Espi, Mercedes, Ibáñez, Josefa, Molina-Barceló, Ana, Pérez, Elena, Nolasco, Andreu, Font, Rebeca, Pérez-Riquelme, Francisco, de la Vega, Mariola, Arana-Arri, Eunate, Oceja, MªElena, Espinàs, Josep Alfons, Portillo, Isabel, Salas, Dolores
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2017
• Subjects: Aged; CCR screening; Colorectal Neoplasms - diagnosis; Early Detection of Cancer; Female; FOBT; Humans; Male; Mass Screening - methods; Middle Aged; Occult Blood; Participation; Patient Participation; Retrospective Studies; Sex Factors; Spain; Participation; FOBT; CRC; CCR screening; CRCSP
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2017.08.019

To analyze the sociodemographic and organizational factors influencing participation in population-based colorectal cancer screening programs (CRCSP) in Spain, a retrospective study was conducted in a cohort of people invited to participate in the first 3 screening rounds of 6 CRCSP from 2000 to 2012. Mixed logistic regression models were used to analyze the relationship between sociodemographic and organizational factors, such as the type of fecal occult blood test (FOBT) used and the FOBT delivery type. The analysis was performed separately in groups (Initial screening-first invitation, Subsequent invitation for previous never-responders, Subsequent invitation-regular, Subsequent invitation-irregular intervals). The results showed that, in the Initial screening-first invitation group, participation was higher in women than in men in all age groups (OR 1.05 in persons aged 50–59years and OR 1.12 in those aged 60–69years). Participation was also higher when no action was required to receive the FOBT kit, independently of the type of screening (Initial screening-first invitation [OR 2.24], Subsequent invitation for previous never-responders [OR 2.14], Subsequent invitation-regular [OR 2.03], Subsequent invitation-irregular intervals [OR 9.38]) and when quantitative rather than qualitative immunological FOBT (FIT) was offered (Initial screening-first invitation [OR 0.70], Subsequent invitation for previous never-responders [OR 0.12], Subsequent invitation-regular [OR 0.20]) or guaiac testing (Initial screening-first invitation [OR 0.81], Subsequent invitation for previous never-responders [OR 0.88], Subsequent invitation-regular [OR 0.73]). In conclusion, the results of this study show that screening participation could be enhanced by inclusion of the FOBT kit with the screening invitation and the use of the quantitative FIT.
•Organizational features of CRCSP can enhance participation rates.•Participation was analyzed by FOBT delivery type and the type of FOBT offered.•Sociodemographic factors were included in the study of CRCSP participation.