Barriers and facilitators towards colonoscopy: a qualitative systematic review

Area of Science:

• Gastroenterology
• Public Health
• Health Services Research

Background:

• Colonoscopy is crucial for early colorectal cancer (CRC) detection, yet uptake remains low globally.
• Stakeholder perspectives on colonoscopy procedures are not well understood, hindering efforts to improve screening rates.
• This systematic review addresses the need to understand barriers and facilitators from both patient and provider viewpoints.

Purpose of the Study:

• To systematically review and synthesize existing literature on barriers and facilitators influencing colonoscopy uptake.
• To identify key themes and perceptions among healthcare providers and patients regarding colonoscopy.
• To provide a foundation for developing interventions aimed at increasing colonoscopy screening rates.

Main Methods:

• A systematic review was conducted following PRISMA guidelines.
• Databases searched included Medline, Embase, CINAHL, PsycINFO, and Web of Science Core Collection.
• Studies included perceptions of healthcare providers and screening participants aged 45 and above.

Main Results:

• Forty-five articles were analyzed, identifying themes such as procedural perceptions, personal experiences, societal influences, and the doctor-patient relationship.
• Knowledge discrepancies between patients and providers have decreased, possibly due to social media.
• Cultural factors, like fatalism in Asian populations, influence attitudes towards CRC diagnosis and screening.

Conclusions:

• Significant gaps in the healthcare system impact colonoscopy uptake.
• Understanding patient and provider perspectives is essential for designing effective interventions.
• Re-evaluating the balance between medical confidentiality and personal patient narratives is needed to enhance trust and encourage screening.