Barriers for Participation in the Danish Colorectal Cancer Screening Program: a Qualitative Study.

Area of Science:

• Public Health
• Preventive Medicine
• Gastroenterology

Background:

• The Danish National Screening Program for Colorectal Cancer (CRCS) has a participation rate of approximately 60%.
• Early detection of colorectal cancer (CRC) through screening significantly reduces mortality rates.
• Understanding barriers to participation is crucial for improving screening program effectiveness.

Purpose of the Study:

• To investigate the reasons behind non-participation in the Danish CRCS program.
• To identify specific barriers hindering individuals from engaging in colorectal cancer screening.

Main Methods:

• Conducted 18 individual semi-structured interviews with non-participants of the CRCS program.
• Analyzed interview data using an inductive hermeneutic approach to identify themes.

Main Results:

• Identified three primary themes of barriers: personal health accountability (forgetfulness, aversion to stool collection, perceived risk), healthcare system attitudes (trust, communication, GP involvement), and knowledge gaps (about CRC and CRCS, preferred information channels, social stigma).
• Non-participation was not typically an active decision to opt-out; most individuals intended to participate.
• A significant finding was the desire for general practitioner (GP) reminders to facilitate screening.

Conclusions:

• Barriers to CRCS participation are multifaceted, involving personal, systemic, and knowledge-based factors.
• Most non-participants expressed an intention to screen, suggesting a need for interventions beyond awareness campaigns.
• Involving general practitioners in reminding patients about screening could be an effective strategy to increase participation in the CRCS program.