scholarly journals Consequences of screening in colorectal cancer (COS-CRC): development and dimensionality of a questionnaire

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Jessica Malmqvist ◽  
Volkert Siersma ◽  
Christine Winther Bang ◽  
John Brodersen
Keyword(s):  
Colorectal Cancer ◽  
Focus Groups ◽  
Content Validity ◽  
Measurement Properties ◽  
Rasch Models ◽  
Ratio Test ◽  
Extended Version ◽  
Single Item ◽  
Crc Screening ◽  
New Information

Abstract Background Harms of colorectal cancer (CRC) screening include psychosocial consequences. We have not identified studies using a participant-relevant questionnaire with adequate measurement properties to investigate these harms. However, Brodersen et al. have previously developed a core questionnaire consequences of screening (COS) for use in screening for life-threatening diseases. Therefore, the objectives were: (1) To investigate content validity of COS in a CRC screening setting and in case of gaps in content coverage (2) generate new items and themes and (3) test the possibly extended version of COS for dimensionality and differential item functioning (DIF) using Rasch Models. Methods We performed two-part-focus-groups with CRC screenees. Screenees were recruited by strategic sampling. In the first part 16 screenees with false-positive results (n = 7) and low-risk polyps (n = 9) were interviewed about their CRC screening experiences and in the second part COS was examined for content validity. When new information was developed in the focus groups, new items covering this topic were generated. Subsequently, new items were, together with COS, tested in the subsequent interviews. A random subsample (n = 410) from a longitudinal questionnaire study, not yet published, was used to form the data for this paper. We analysed multidimensionality and uniform DIF with Andersen’s conditional likelihood ratio test. We assessed individual item fit to the model. We also analysed Local Dependence (LD) and DIF by partial gamma coefficients using Rasch Models. Results COS was found relevant in a CRC screening setting. However, new information was discovered in the focus groups, covered by 18 new CRC screening-specific items. The Rasch analyses only revealed minor problems in the COS-scales. The 18 new items were distributed on four new CRC screening-specific dimensions and one single item. Conclusion An extended version of COS specifically for use in a CRC screening setting has been developed. The extended part encompasses four new scales and one new single item. The original COS with the CRC-screening specific extension is called consequences of screening in colorectal cancer (COS-CRC). COS-CRC possessed reliability, unidimensionality and invariant measurement.

scholarly journals Barriers and Facilitators to Colorectal Cancer Screening Within a Hispanic Population

2018 ◽  
Vol 17 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Theresa L. Byrd ◽  
Jessica Calderón-Mora ◽  
Rebekah Salaiz ◽  
Navkiran K. Shokar
Keyword(s):  
Colorectal Cancer ◽  
Focus Groups ◽  
Screening Program ◽  
El Paso ◽  
Barriers And Facilitators ◽  
Hispanic Population ◽  
Community Based ◽  
Crc Screening ◽  
Predominantly Hispanic ◽  
9Th Grade

Introduction: Colorectal cancer (CRC) is the third leading cancer cause of death among US Hispanics. CRC screening among the Hispanic population is lower compared with non-Hispanic Whites. Method: The purpose of this qualitative, exploratory study was to better understand the barriers and facilitators of CRC screening and preference for stool-based testing collection methods among the predominantly Hispanic population of El Paso, Texas. Nine focus groups were conducted by a trained bilingual facilitator with a moderator guide informed by the literature. Transcripts of the focus groups were entered into qualitative analysis software and a thematic network was developed. Results: Fifty-six participants were recruited: average age was 68.5 years, 58.9% were female, 98.2% were Hispanic, 87.5% had an annual income of less than $20,000, 58.9% had 9th grade education or less, 12.5% had a discount program, and 5.4% had no insurance. Barriers to CRC screening included cost, fear, and embarrassment. Facilitators to screening included in-person health education and physician recommendation. Participants preferred the hygienic nature of a stool test collected with a brush and bottle. Conclusion: Overall, there was a lack of knowledge regarding CRC and significant barriers to CRC screening. A community-based CRC screening program was subsequently developed from our findings.

scholarly journals Colorectal cancer screening behaviors among South Asian immigrants in Canada: a qualitative study

2015 ◽  
Vol 11 (2) ◽  
pp. 130-146 ◽  
Author(s):  
Joanne Crawford ◽  
Farah Ahmad ◽  
Dorcas E. Beaton ◽  
Arlene S. Bierman
Keyword(s):  
Colorectal Cancer ◽  
Focus Groups ◽  
South Asian ◽  
Cultural Context ◽  
Future Research ◽  
Average Risk ◽  
Collaborative Partnerships ◽  
Structural Barriers ◽  
Content Type ◽  
Crc Screening

Purpose – The purpose of this paper is to gain an in-depth understanding of beliefs, attitudes, and reasons for decision making about colorectal cancer (CRC) screening among South Asian (SA) immigrants. Design/methodology/approach – Six focus groups conducted in English, Punjabi, and Urdu were held with 42 SA immigrants, 50-74 years old and at average risk for CRC, from November 2012 to May 2013. All focus group discussions were audio-taped and transcribed verbatim. Data analysis used an inductive and systematic approach employing constant comparison techniques. Findings – Three dominant themes emerged. Beliefs and attitudes towards cancer and screening represented SA immigrant’s perceptions that early detection was beneficial; screening was not necessary in the absence of symptoms; cancer was scary; and the loss of previously established bowel practices upon immigration as potential risks for CRC. Knowledge and awareness focused on unscreened participants’ cancer stories; screened participants’ knowledge of CRC, risk factors, and screening; experiential learning from focus groups; and screened participants’ strategies to promote screening. Support and accessibility concentrated on physician support and responsibility to provide information, explanation, and recommend screening to facilitate access. Originality/value – Findings provide novel insights on socio-cultural context, beliefs, and barriers to CRC screening among SA immigrants. Culturally appropriate community-based strategies included story-telling, the use of social networks, and greater physician engagement. Enhancing collaborative partnerships with physicians and public health may minimize structural barriers and reduce health disparities. Future research could explore effectiveness of outreach strategies including these collaborations.

scholarly journals Barriers to and Facilitators of Colorectal Cancer Screening in Egypt: Examining the Perceptions of Physicians and Residents in Alexandria

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 40-40
Author(s):  
Lori Brand Bateman ◽  
Somaia Khamess ◽  
Ahmed Nawar ◽  
Salah-Eldin Abdelmoneim ◽  
Waleed Arafat ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Focus Group ◽  
Early Detection ◽  
Focus Groups ◽  
Primary Care Physicians ◽  
Screening Program ◽  
Low Cost ◽  
Screening Tests ◽  
Structural Level ◽  
Crc Screening

PURPOSE Colorectal cancer (CRC) screening is not routinely performed in Egypt, and more than one third of CRC cases occur in individuals age 40 and younger, with overall survival estimated at only 2 years, presumably because of late diagnoses. To lay the foundation for the development of a CRC multilevel screening program in Egypt to promote CRC prevention and early detection, this qualitative study aimed to explore the potential barriers to and facilitators of screening from the perspectives of physicians and residents in Alexandria. METHODS We conducted one-on-one, 1-hour, semistructured interviews with primary health care physicians and specialists—oncologists and gastroenterologists—practicing in Alexandria, Egypt. Focus groups of residents, stratified by social class and gender, were also held. Interviews and focus groups were conducted in Arabic by trained interviewers/moderator, and were audio recorded, transcribed, translated into English, and analyzed using thematic analysis. RESULTS Seventeen physicians participated—8 specialists and 9 primary care physicians—and 7 focus groups—7 to 8 participants each—were held. According to both interview and focus group participants, individual-level barriers to CRC screening included socioeconomic status, a lack of emphasis on prevention in the culture, fear, and cost. Provider-level barriers as mentioned by physicians included a belief that only high-risk patients should be screened and a lack of confidence in providers to perform and interpret screening tests appropriately. Structural-level barriers, discussed by physicians and focus group participants, included cost and a lack of testing availability. Potential facilitators of screening mentioned by physicians included implementing a media campaign emphasizing early detection and curability. Focus group participants focused on making screening tests free or low cost, obligatory, and convenient. CONCLUSION On the basis of the perceptions of physicians and residents of Alexandria, Egypt, multiple barriers to and facilitators of CRC screening exist. Addressing these would be important in designing a successful screening program.

scholarly journals Development of a Group-Based Community Health Worker Intervention to Increase Colorectal Cancer Screening Among Latinos

2020 ◽  
pp. 154041532092356
Author(s):  
C. L. De La Torre ◽  
J. N. Dumbauld ◽  
J. Haughton ◽  
S. Gupta ◽  
J. Nodora ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Focus Groups ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Community Advisory Board ◽  
Community Based ◽  
Latino Men ◽  
Crc Screening

Introduction: Latinos are at higher risk of colorectal cancer (CRC) mortality than non-Hispanic Whites due, in part, to disparities in cancer screening. There is a need to evaluate community-based CRC interventions as they may reach underinsured communities and those at highest risk for CRC. This article describes the development of a group-based CRC intervention ( Juntos contra el Cancer). Method: Purposive sampling was used to recruit Latino men and women aged 50 to 75 years not-up-to-date with CRC screening. The development of the intervention was guided by the socioecologic framework, a community needs assessment, literature reviews, five focus groups ( n = 39) from the target community and feedback from a Community Advisory Board. Results: Findings from focus groups suggested that a group-based, promotor or community health worker (CHW) led, cancer prevention education with linkages to care would address barriers to CRC screening. Conclusion: Development of community-based CRC screening interventions should be informed by early and sustained community engagement. Interventions led by CHWs with linkages to care are feasible and can reach populations not connected to health care settings.

scholarly journals National Colorectal Cancer Screening Program in Lithuania: Description of the 5-Year Performance on Population Level

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1129
Author(s):  
Audrius Dulskas ◽  
Tomas Poskus ◽  
Inga Kildusiene ◽  
Ausvydas Patasius ◽  
Rokas Stulpinas ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Quality Assurance ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Histopathological Examination ◽  
Insurance Fund ◽  
Crc Screening ◽  
Cancer Screening Program ◽  
The Impact

We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program.

scholarly journals Colorectal cancer screening using a stool DNA-based SDC2 methylation test: a multicenter, prospective trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chang Woo Kim ◽  
Hyunjin Kim ◽  
Hyoung Rae Kim ◽  
Bong-Hyeon Kye ◽  
Hyung Jin Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Early Detection ◽  
Prospective Trial ◽  
Screening Colonoscopy ◽  
Quantitative Detection ◽  
Screening Programs ◽  
Crc Screening ◽  
Stool Dna ◽  
Dna 2

Abstract Background Prevention and early detection of colorectal cancer (CRC) is a global priority, with many countries conducting population-based CRC screening programs. Although colonoscopy is the most accurate diagnostic method for early CRC detection, adherence remains low because of its invasiveness and the need for extensive bowel preparation. Non-invasive fecal occult blood tests or fecal immunochemical tests are available; however, their sensitivity is relatively low. Syndecan-2 (SDC2) is a stool-based DNA methylation marker used for early detection of CRC. Using the EarlyTect™-Colon Cancer test, the sensitivity and specificity of SDC2 methylation in stool DNA for detecting CRC were previously demonstrated to be greater than 90%. Therefore, a larger trial to validate its use for CRC screening in asymptomatic populations is now required. Methods All participants will collect their stool (at least 20 g) before undergoing screening colonoscopy. The samples will be sent to a central laboratory for analysis. Stool DNA will be isolated using a GT Stool DNA Extraction kit, according to the manufacturer’s protocol. Before performing the methylation test, stool DNA (2 µg per reaction) will be treated with bisulfite, according to manufacturer’s instructions. SDC2 and COL2A1 control reactions will be performed in a single tube. The SDC2 methylation test will be performed using an AB 7500 Fast Real-time PCR system. CT values will be calculated using the 7500 software accompanying the instrument. Results from the EarlyTect™-Colon Cancer test will be compared against those obtained from colonoscopy and any corresponding diagnostic histopathology from clinically significant biopsied or subsequently excised lesions. Based on these results, participants will be divided into three groups: CRC, polyp, and negative. The following clinical data will be recorded for the participants: sex, age, colonoscopy results, and clinical stage (for CRC cases). Discussion This trial investigates the clinical performance of a device that allows quantitative detection of a single DNA marker, SDC2 methylation, in human stool DNA in asymptomatic populations. The results of this trial are expected to be beneficial for CRC screening and may help make colonoscopy a selective procedure used only in populations with a high risk of CRC. Trial registration: This trial (NCT04304131) was registered at ClinicalTrials.gov on March 11, 2020 and is available at https://clinicaltrials.gov/ct2/show/NCT04304131?cond=NCT04304131&draw=2&rank=1.

scholarly journals Effect of Neighborhood and Individual-Level Socioeconomic Factors on Colorectal Cancer Screening Adherence

2021 ◽  
Vol 18 (9) ◽  
pp. 4398
Author(s):  
Kiara N. Mayhand ◽  
Elizabeth A. Handorf ◽  
Angel G. Ortiz ◽  
Evelyn T. Gonzalez ◽  
Amie Devlin ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Study Participant ◽  
Socioeconomic Indicators ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Total Study Population ◽  
Screening Guidelines ◽  
Individual Level ◽  
Crc Screening ◽  
Screening Adherence

Despite the effectiveness of screenings in reducing colorectal cancer (CRC) mortality, ~25% of US adults do not adhere to screening guidelines. Prior studies associate socioeconomic status (SES) with low screening adherence and suggest that neighborhood deprivation can influence CRC outcomes. We comprehensively investigated the effect of neighborhood SES circumstances (nSES), individual SES, and race/ethnicity on adherence to CRC screening in a multiethnic cross-sectional study. Participant surveys assessing 32 individual-level socioeconomic and healthcare access measures were administered from 2017 to 2018. Participant data were joined with nine nSES measures from the US Census at the census tract level. Univariate, LASSO, and multivariable mixed-effect logistic regression models were used for variable reduction and evaluation of associations. The total study population included 526 participants aged 50–85; 29% of participants were non-adherent. In the final multivariable model, age (p = 0.02) and Non-Hispanic Black race (p = 0.02) were associated with higher odds of adherence. Factors associated with lower adherence were home rental (vs. ownership) (p = 0.003), perception of low healthcare quality (p = 0.006), no routine checkup within two years (p = 0.002), perceived discrimination (p = 0.02), and nSES deprivation (p = 0.02). After comprehensive variable methods were applied, socioeconomic indicators at the neighborhood and individual level were found to contribute to low CRC screening adherence.

scholarly journals To do or not to do – a survey study on factors associated with participating in the Danish screening program for colorectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jesper Bo Nielsen ◽  
Gabriele Berg-Beckhoff ◽  
Anja Leppin
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Demographic Data ◽  
Survey Study ◽  
Stepwise Logistic Regression ◽  
Willingness To Participate ◽  
Cross Sectional Survey ◽  
Screening Programs ◽  
Crc Screening ◽  
Screening Participation

Abstract Background Screening programs for colorectal cancer (CRC) exist in many countries, and with varying participation rates. The present study aimed at identifying socio-demographic factors for accepting a cost-free screening offer for CRC in Denmark, and to study if more people would accept the screening offer if the present fecal test was replaced by a blood test. Methods We used a cross-sectional survey design based on a representative group of 6807 Danish citizens aged 50–80 years returning a fully answered web-based questionnaire with socio-demographic data added from national registries. Data were analyzed in STATA and based on bivariate analyses followed by regression models. Results Danes in general have a high level of lifetime participation (+ 80%) in the national CRC screening program. The results of the stepwise logistic regression model to predict CRC screening participation demonstrated that female gender, higher age, higher income, and moderate alcohol intake were positively associated with screening participation, whereas a negative association was observed for higher educational attainment, obesity, being a smoker, and higher willingness to take health risks. Of the 1026 respondents not accepting the screening offer, 61% were willing to reconsider their initial negative response if the fecal sampling procedure were replaced by blood sampling. Conclusion The CRC screening program intends to include the entire population within a certain at-risk age group. However, individual factors (e.g. sex, age obesity, smoking, risk aversity) appear to significantly affect willingness to participate in the screening program. From a preventive perspective, our findings indicate the need for a more targeted approach trying to reach these groups.

scholarly journals Evaluation of Blood Stool Test Utilization for Colorectal Cancer Screening in Georgia, USA

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 569
Author(s):  
Benjamin E. Ansa ◽  
Nicollette Lewis ◽  
Zachary Hoffman ◽  
Biplab Datta ◽  
J. Aaron Johnson
Keyword(s):  
Colorectal Cancer ◽  
Insurance Coverage ◽  
The United States ◽  
Sociodemographic Factors ◽  
Behavioral Risk ◽  
Early Screening ◽  
Annual Percent Change ◽  
Crc Screening ◽  
Behavioral Risk Factor Surveillance ◽  
And Control

Colorectal cancer (CRC) is the third most prevalent cancer and the second most common cause of cancer-related deaths in the United States (USA). Early screening has been demonstrated to improve clinical outcomes for CRC. Assessing patterns in CRC screening utilization is important for guiding policy and implementing programs for CRC prevention and control. This study examines the trends and sociodemographic factors associated with blood stool test utilization (BSTU) for CRC screening in Georgia, USA. The Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed for Average Annual Percent Change (AAPC) in BSTU between 1997 and 2014 among adults aged 50+ who have had a blood stool test within the past two years, and logistic regression analysis of the 2016 data was performed to identify the associated sociodemographic factors. In Georgia, an overall decrease was observed in BSTU, from 27.8% in 1997 to 16.1% in 2014 (AAPC = −2.6, p = 0.023). The decrease in BSTU was less pronounced in Georgia than nationally (from 26.1% in 1997 to 12.8% in 2014 (AAPC = −4.5, p < 0.001)). BSTU was significantly associated with black race/ethnicity (Black vs. White (aOR = 1.43, p = 0.015)), older age (≥70 vs. 50–59 (aOR = 1.62, p = 0.006)), having insurance coverage (no vs. yes (aOR = 0.37 p = 0.005)), and lower income (≥USD 50,000 vs. <USD 25,000 (aOR = 0.70 p = 0.050)). These findings reveal a decrease over time in BSTU in Georgia, with existing differences between sociodemographic groups. Understanding these patterns helps in directing tailored programs for promoting CRC screening, especially among disadvantaged populations.

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