Colonoscopy is the preferred colorectal cancer screening method in a population-based program.

Area of Science:

• Gastroenterology
• Public Health
• Oncology

Background:

• Professional societies promote various colorectal cancer (CRC) screening methods.
• Limited data exist on factors influencing patient participation in CRC screening programs.
• Understanding participation determinants is crucial for population-based screening success.

Purpose of the Study:

• Identify factors influencing CRC screening acceptance and method preference.
• Evaluate colonoscopy success, neoplasia detection, and patient satisfaction.

Main Methods:

• A public awareness campaign offered CRC screening to individuals aged 50-80.
• Screening options included fecal occult blood tests, flexible sigmoidoscopy, a combination, or colonoscopy.

Main Results:

• Only 12.0% of the target population participated in screening.
• Access to information and positive attitudes were key participation drivers.
• Colonoscopy was preferred by 74.8%; advanced neoplasia found in 8.5% (higher in males, increasing with age).
• Colonoscopy complications occurred in 0.5% (related to polypectomy/sedation).
• Over 90% of patients were satisfied and would choose colonoscopy again.

Conclusions:

• Low CRC screening uptake was observed despite an extensive information campaign.
• Colonoscopy emerged as a preferred and safe screening modality.
• Demographic factors and screening determinants can inform improved screening strategies.