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Published on: August 1, 2019
Participation in colorectal cancer screening trials after first-time invitation: a systematic review
C Khalid-de Bakker1, D Jonkers, K Smits
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, The Netherlands. carolina.khalid@intmed.unimaas.nl
Background And Study Aim:
Colorectal cancer (CRC) screening is implemented by an increasing number of countries. Participation rates of screening programs influence the health benefit and cost-effectiveness of the applied method. The aim was to systematically review participation rate after first-time invitation for CRC screening with fecal occult blood test (FOBT), sigmoidoscopy, colonoscopy, and/or computed tomography (CT) colonography.
Methods:
A systematic literature search was performed prior to October 1 2009. Prospective CRC screening studies of unselected populations reporting participation rates were included.
Results:
After meta-analyses, overall participation rates were found to be 47 % for FOBT, 42 % for fecal immunologic tests (FITs), 35 % for sigmoidoscopy, 41 % for sigmoidoscopy combined with FIT/FOBT, 28 % for colonoscopy, and 22 % for CT colonography. Studies comparing screening methods showed higher participation rates for less invasive methods. Studies comparing invitation methods showed higher participation rates with general practitioner involvement, a more personalized recruitment approach, and reduction of barriers that discourage participation.
Conclusions:
Knowledge of identified factors affecting CRC screening participation can be used to improve screening programs.
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