Factors that could influence women's participation in colorectal cancer screening: an Italian study

Colorectal cancer (CRC) is the 2nd most common cancer in women worldwide. In Italy, only 50% of people invited to get the Fecal Occult Blood Test (FOBT) decided to do it. Women's participation in breast and cervical screening is, instead, very high (>70%). The aim of our study was to investigate the beliefs, the feelings and the psychological factors that could influence the participation of women in CRC screening.

We conducted a cross sectional study, in the Hospital of Siena, Central Italy, in 2011. We administered a questionnaire to 507 women of all ages, who attended mammography or clinical breast examination. The adherence to CRC screening was analyzed only in the group of 207 older women (age >50 years). We performed descriptive, bivariate and logistic regression analysis to identify whether an association was present between participant characteristics, willingness and adherence to screening.

Family history of colorectal cancer (OR 4.3; p<0.007) and the General Practitioner's advice (OR: 3.4; p<0.003) were associated with a greater adherence to screening (colonoscopy). The embarrassment was another factor related to colonoscopy compliance (OR: 0.34; p<0.016).

Family history of CRC, pain or embarassment and GP's advice are the factors that correlated more strongly (positively or negatively) with adherence to colorectal cancer screening. These elements should be further analyzed to choose the best solution to improve the adherence in campaigns on colorectal cancer.