Identifying the main barriers for participation in a population-based colorectal cancer screening programme in East Azerbaijan, Iran

Roya Dolatkhah; Mohammad Hossein Somi; Saeed Dastgiri; Mohammad Asghari Jafarabadi; Bita Sepehri; Masoud Shirmohammadi; Marzieh Nezamdoust; Hossein Mashhadi Abdolahi; Faris Farassati

doi:10.3332/ecancer.2022.1354

Identifying the main barriers for participation in a population-based colorectal cancer screening programme in East Azerbaijan, Iran

Ecancermedicalscience. 2022 Feb 10:16:1354. doi: 10.3332/ecancer.2022.1354. eCollection 2022.

Authors

Affiliations

¹ Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, PO Box: 5166614731.
² https://orcid.org/0000-0002-6897-7120.
³ Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, PO Box: 5166614756.
⁴ https://orcid.org/0000-0002-6611-9958.
⁵ Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, PO Box: 5166615739.
⁶ https://orcid.org/0000-0002-8129-9125.
⁷ Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran and, Center for the Development of Interdisciplinary Research in Islamic Sciences and Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran, PO Box: 5463789200.
⁸ Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, PO Box: 5165990001.
⁹ Midwest Biomedical Research Foundation, Kansas City, MO 64128, USA.

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of death worldwide. However, CRC is considered as one of the most preventable cancers by which the mortality rates reduce about 60% through implementing the screening programmes. The present study aimed to evaluate the main barriers of CRC screening in a defined population.

Method: Healthy individuals from all regions of the state were invited to participate in different healthcare centres. They were assessed by a provided online risk assessment tool, which was completed for all recruited subjects, and has been developed to assess the CRC risk based on personal and family history of adenoma, CRC, and other high-risk diseases. Research team staff assessed all individuals by this tool and then eligible people according to their lifetime risk of CRC were included in the study. There was not any age restriction in this study. Colonoscopy and three stool-based tests including faecal occult blood test, faecal immunochemical test and stool DNA tests were performed.

Results: Overall, 725 cases including 425 (58.6%) males and 300 (41.4%) females participated in the study. Lack of knowledge and attitude about screening programmes was the most common barrier, especially among women (68% for women versus 58% for men) and those from rural areas (88% in rural versus 55% in urban areas). Fear of colonoscopy and procedure complications and pain (48%), discomfort and anxiety from inserting a tube into the bowel (65% among females versus 43% among males) were reported commonly. Embarrassment and dignity were other complaints, especially in women (62% in females versus 35% in males).

Conclusion: Increasing knowledge and attitude about the aims and benefits of screening programmes, acceptable and convenient communication of health systems with the general population are considered to be the key elements in the success and implementation of any screening programme.

Keywords: barrier; colorectal cancer; screening.