scholarly journals Barriers and facilitators for colorectal cancer screening in a low-income urban community in Mexico City

2020 ◽  
Author(s):  
Karla Unger-Saldaña ◽  
Minerva Saldaña-Tellez ◽  
Michael B. Potter ◽  
Katherine Van Loon ◽  
Betania Allen-Leigh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Barriers And Facilitators ◽  
Health Care Personnel ◽  
Crc Screening ◽  
Lay Beliefs ◽  
The Social

Abstract Background. Colorectal cancer (CRC) incidence and mortality are increasing in many middle- and lower-income countries, possibly due to a combination of changing lifestyles and improved healthcare infrastructure that facilitates diagnosis. Unfortunately, a large proportion of cases may be diagnosed at advanced stages, resulting in poor outcomes. Decreasing trends in higher income countries are likely due to improved early detection combined with best practices in CRC treatment and management. More data on implementation of better quality CRC screening programs are needed for contexts where incidence is increasing. Therefore, we sought to identify potential barriers and facilitators for future implementation of fecal immunochemical test (FIT)-based CRC screening in a public healthcare system in a middle-income country with increasing CRC incidence and mortality.Methods. Qualitative study including semi-structured individual and focus group interviews with different stakeholders of colorectal cancer screening: 30 average-risk lay people, 13 health care personnel from a local public clinic, and 7 endoscopy unit personnel from a cancer referral hospital. All interviews were transcribed verbatim for analysis. Data was analyzed using the constant comparison method, under the theoretical perspectives of the Social Ecological Model (SEM), the PRECEDE-PROCEED Model, and the Health Belief Model. Results. We found multiple barriers and facilitators for implementation of a FIT-based CRC screening program at different levels of the SEM. The main barriers in each of the SEM levels, were: 1) at the social context level: poverty, health literacy and lay beliefs related to gender, cancer, allopathic medicine, and religion; 2) at the health services organization level: the lack of CRC knowledge among health care personnel and the community perception of poor quality of health care; 3) at the individual level: a lack of CRC awareness and therefore lack of risk perception, together with fear of participating in screening activities and finding out about a serious disease. The main facilitators perceived by the participants were CRC screening information and the free provision of screening tests.Conclusions. This study’s findings suggest the need for a multi-level CRC screening program that includes complementary strategies aimed at reducing perceived barriers and enhancing facilitators, starting with: 1) free provision of screening tests, 2) education of primary health care personnel, and 3) promotion of non fear-based CRC screening awareness among the target population, taking into account their lay beliefs.

scholarly journals Barriers and facilitators for colorectal cancer screening in a low-income urban community in Mexico City

2020 ◽  
Author(s):  
Karla Unger-Saldaña ◽  
Minerva Saldaña-Tellez ◽  
Michael B. Potter ◽  
Katherine Van Loon ◽  
Betania Allen-Leigh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Screening ◽  
Screening Program ◽  
Barriers And Facilitators ◽  
Health Care Personnel ◽  
Crc Screening ◽  
Lay Beliefs ◽  
Incidence And Mortality ◽  
The Social

Abstract Background Colorectal cancer (CRC) incidence and mortality are increasing in many middle- and lower-income countries, possibly due to a combination of changing lifestyles and improved healthcare infrastructure that facilitates diagnosis. Unfortunately, a large proportion of cases may be diagnosed at advanced stages, resulting in poor outcomes. Decreasing trends in higher income countries are likely due to improved early detection combined with best practices in CRC treatment and management. More data on implementation of better quality CRC screening programs are needed for contexts where incidence is increasing. Therefore, we sought to identify potential barriers and facilitators for future implementation of fecal immunochemical test (FIT)-based CRC screening in a public healthcare system in a middle-income country with increasing CRC incidence and mortality. Methods. Qualitative study including semi-structured individual and focus group interviews with different stakeholders of colorectal cancer screening: 30 average-risk lay people, 13 health care personnel from a local public clinic, and 7 endoscopy unit personnel from a cancer referral hospital. All interviews were transcribed verbatim for analysis. Data was analyzed using the constant comparison method, under the theoretical perspectives of the Social Ecological Model (SEM), the PRECEDE-PROCEED Model, and the Health Belief Model. Results. We found multiple barriers and facilitators for implementation of a FIT-based CRC screening program at different levels of the SEM. The main barriers in each of the SEM levels, were: 1) at the social context level: poverty, health literacy and lay beliefs related to gender, cancer, allopathic medicine, and religion; 2) at the health services organization level: the lack of CRC knowledge among health care personnel and the community perception of poor quality of health care; 3) at the individual level: a lack of CRC awareness and therefore lack of risk perception, together with fear of participating in screening activities and finding out about a serious disease. The main facilitators perceived by the participants were CRC screening information and the free provision of screening tests.Conclusions. This study’s findings suggest the need for a multi-level CRC screening program that includes complementary strategies aimed at reducing perceived barriers and enhancing facilitators, starting with: 1) free provision of screening tests, 2) education of primary health care personnel, and 3) promotion of non fear-based CRC screening awareness among the target population, taking into account their lay beliefs.

scholarly journals Barriers and facilitators for colorectal cancer screening in a low-income urban community in Mexico City

2020 ◽  
Author(s):  
Karla Unger-Saldaña ◽  
Minerva Saldaña-Tellez ◽  
Michael B. Potter ◽  
Katherine Van Loon ◽  
Betania Allen-Leigh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Barriers And Facilitators ◽  
Health Care Personnel ◽  
Middle Income ◽  
Crc Screening ◽  
Middle Income Countries ◽  
Lay Beliefs ◽  
Incidence And Mortality ◽  
The Social

Abstract Background. Colorectal cancer (CRC) incidence and mortality are increasing in many low- and middle-income countries (LMICs), possibly due to a combination of changing lifestyles and improved healthcare infrastructure to facilitate diagnosis. Unfortunately, a large proportion of CRC cases in these countries remain undiagnosed or are diagnosed at advanced stages, resulting in poor outcomes. Decreasing mortality trends in HICs are likely due to evidence-based screening and treatment approaches that are not widely available in LMICs. Formative research to identify emerging opportunities to implement appropriate screening and treatment programs in LMICs is, therefore, of growing importance. We sought to identify potential barriers and facilitators for future implementation of fecal immunochemical test (FIT)-based CRC screening in a public healthcare system in a middle-income country with increasing CRC incidence and mortality. Methods. We performed a qualitative study with semi-structured individual and focus group interviews with different CRC screening stakeholders, including: 30 lay people at average risk for CRC; 13 health care personnel from a local public clinic; and 7 endoscopy personnel from a cancer referral hospital. All interviews were transcribed verbatim for analysis. Data were analyzed using the constant comparison method, under the theoretical perspectives of the Social Ecological Model (SEM), the PRECEDE-PROCEED Model, and the Health Belief Model. Results. We identified barriers and facilitators for implementation of a FIT-based CRC screening program at several levels of the SEM. The main barriers in each of the SEM levels, were: 1) at the social context level: poverty, health literacy and lay beliefs related to gender, cancer, allopathic medicine, and religion; 2) at the health services organization level: a lack of CRC knowledge among health care personnel and the community perception of poor quality of health care; 3) at the individual level: a lack of CRC awareness and therefore lack of risk perception, together with fear of participating in screening activities and finding out about a serious disease. The main facilitators perceived by the participants were CRC screening information and the free provision of screening tests.Conclusions. This study’s findings suggest that multi-level CRC screening programs in middle income countries such as Mexico should incorporate complementary strategies to address barriers and facilitators, such as: 1) provision of free screening tests, 2) education of primary healthcare personnel, and 3) promotion of non fear-based CRC screening messages to the target population, tailored to address common lay beliefs.

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.

The effectiveness of colorectal cancer screening for cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16091-e16091
Author(s):  
Chia-Jen Liu ◽  
Tzu-Yu Lai ◽  
Chiu-Mei Yeh ◽  
Chun-Kuang Tsai ◽  
Po-Min Chen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Cancer Survivors ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Multidisciplinary Treatment ◽  
Study Cohort ◽  
Screening Programs ◽  
Crc Screening ◽  
Comparison Groups

e16091 Background: Colorectal cancer (CRC) is one of the highest-incident neoplasms in many countries. Although the incidence of CRC is increasing gradually, the mortality rate has not increased due to early detection and multidisciplinary treatment. CRC screening programs, including colonoscopy and fecal occult blood tests, have been reducing CRC-related mortality worldwide. In Taiwan, the CRC screening program uses a biennial fecal immunochemical test (FIT) as the initial screening tool. FIT-positive participants receive a colonoscopy as a CRC confirmation examination. Cancer survivors have a higher incidence of secondary primary malignancies. Methods: We conducted a nationwide population-based study in Taiwan. The cancer survivors with FIT in the Nationwide Colorectal Cancer Screening (NCCS) Program between January 2010 and September 2014 were enrolled as the study group. The patients aged under 50, diagnosed with CRC before the FIT were excluded. The screening participants without a cancer history were served as the comparison group. The primary endpoint was CRC diagnosis within six months after a FIT. The cancer diagnosis was identified by using Taiwan Cancer Registry. The ratios of positive FIT, confirmatory colonoscopy, and CRC diagnosis in the cancer survivors and the comparison cohort were calculated and compared. Analyses were adjusted for participants’ characteristics by using multilevel logistic regression models. Results: We identified 288,919 cancer survivors who participated in the NCCS Program. Of them, 41.1% were male and the median age was 59 (interquartile ranges 54–64). There were 417,907 FITs performed in the study cohort. The FIT positive rates were 11.3% and 7.4% in the study and comparison groups, respectively (OR 1.59 95% CI 1.57–1.60). Of the FIT positive participants, 50.5% and 52.3% received confirmatory colonoscopy or the related examinations within six months, respectively (OR 0.93 95% CI 0.91–0.95). Then 3.0% and 4.4% of those receiving confirmatory colonoscopy were diagnosed with CRC in the study and comparison groups, respectively (OR 0.68 95% CI 0.63–0.74). After adjustment for age, sex, income, a family history of CRC, and comorbidities, the cancer survivors in this screening program had a similar rate of CRC diagnosis compared with those without antecedent malignancies (adjusted OR: 0.97, 95% CI 0.87–1.08). Conclusions: Although the cancer survivors had a higher rate of positive FIT, the CRC diagnosed by the screening did not increase. We further identified the risk factors associated with CRC in the cancer survivors.

scholarly journals Report on the Expert Forum on using Information Technology to Facilitate Uptake and Impact of Colorectal Cancer Screening Guidelines

2012 ◽  
Vol 26 (12) ◽  
pp. 902-904 ◽  
Author(s):  
Maida J Sewitch ◽  
Mengzhu Jiang ◽  
Alan N Barkun ◽  
David Armstrong ◽  
Donna Manca ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Information Technology ◽  
Cancer Screening ◽  
Data Collection ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Preventive Health Care ◽  
Screening Guidelines ◽  
Screening Programs ◽  
Crc Screening

The present report summarizes the proceedings of the pan-Canadian Expert Forum on Using Information Technology to Facilitate Uptake and Impact of Colorectal Cancer Screening Guidelines, which was held in Montreal, Quebec, November 18 to 19, 2011. The meeting assembled a multidisciplinary group of family physicians, gastroenterologists, nurses, patients, foundation representatives, screening program administrators and researchers to discuss the development of a mechanism or strategy that would permit the collection of comparable data by all colorectal cancer (CRC) screening programs, which would not only support the needs of each program but also provide a national perspective. The overarching theme of the meeting was ‘designing a national approach to computerized electronic data collection and dissemination for CRC screening that would improve knowledge transfer across the continuum of preventive health care’. The forum encouraged presentations on clinical, research and technical topics. The meeting fostered valuable cross-disciplinary communication and delivered the message that it is essential to develop a national health informatics approach for CRC screening data collection and dissemination to support provincial CRC screening programs.

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