Barriers and Facilitators to Colorectal Cancer Screening: Providers' Perspective

Colorectal cancer ranks as the third most prevalent cancer worldwide and the second most prevalent cancer in Saudi Arabia. Additionally, it stands as the second leading cause of cancer-related mortality globally. There is an increasing incidence of colorectal cancer worldwide. However, there is a notable decrease in incidence in high-income countries due to effective screening programs.

The aim of this study was to identify the facilitators and barriers to the utilization of colorectal cancer screening from healthcare providers' perspective.

A qualitative study was conducted at multiple centres using semi-structured interviews to explore the perspectives of primary healthcare physicians, gastrointestinal physicians, and colorectal surgeons on colorectal cancer screening in Dammam, Al-Khobar, and Al-Qatif in the Eastern Province of Saudi Arabia. Forty participants were involved in this study, leading to the identification of several barriers and facilitators to colorectal cancer screening.

Health system-related barriers included the unavailability of screening methods, such as FIT tests, or endoscopy units in some centres, high patient load, and the absence of a national screening program. Facilitators included easy access to screening guidelines, collaboration between hospitals, and the presence of female endoscopists. Individuals-related barriers encompassed patient unwillingness to screen, fear, lack of awareness, social and cultural factors, and inconvenience. Alternatively, the presence of a family history of colorectal cancer, GI symptoms, and higher education levels were considered as facilitators.

This study emphasizes the importance of implementing structural changes within the healthcare system, alongside raising awareness, and educating citizens. It also stresses the utilization of the effective strategies identified in this study regarding patient-provider communication to target individuals-related barriers and enhance screening rates.