Optimising colorectal cancer screening acceptance: a review

Anticipated dislike or discomfort can negatively influence completion of the CRC stool test at home.

“Anticipated dislike or discomfort [27,28] and disgust related to handling stool [27,29] can negatively influence completion of the CRC stool test at home.”

Primary care providers' or general practitioners' endorsement, encouragement and recommendations to attend cancer screening are often key.

“Primary care providers' or general practitioners' (GP) endorsement, encouragement and recommendations to attend cancer screening are often key [e.g., 15,28,35], and might be particularly important for subpopulations, e.g., immigrants [7].”

No gender difference was observed in an English pilot study of female nurse-delivered screening for female patients.

“Similarly, for CRC, women might prefer having the exam performed by a female endoscopist [28], though no gender difference was observed in an English pilot study of female nurse-delivered screening for female patients [28].”

Physician reminders can be effective only for individuals who have access to and make use of healthcare services.

“For example, physician reminders can be effective only for individuals who have access to and make use of healthcare services [28].”

Invitations and reminder systems might be mostly effective for those who already have access to healthcare and are able to use the services.

“However, they might be mostly effective for those who already have access to healthcare and are able use the services [28].”

For CRC, women might prefer having the exam performed by a female endoscopist.

“Similarly, for CRC, women might prefer having the exam performed by a female endoscopist [28], though no gender difference was observed in an English pilot study of female nurse-delivered screening for female patients [28].”

In a review of randomised trials to increase CRC home-testing, a letter signed by the patient's GP was moderately effective in increasing home-testing compared to letters from different authorities.

“In a review of randomised trials to increase CRC home-testing, a letter signed by the patient's GP was moderately effective in increasing home-testing compared to letters from different authorities [28].”

For CRC, primary clinics where the nonphysician staff identifies subjects eligible for screening and offers counselling about testing or assistance to fix an appointment have shown increased screening rates.

“For CRC, primary clinics where the nonphysician staff identifies subjects eligible for screening and offers counselling about testing or assistance to fix an appointment have shown increased screening rates [28].”

Feedback on screening rates and relative performance may reinforce providers' commitment to promote screening.

“Feedback on screening rates and relative performance may reinforce providers' commitment to promote screening [28].”

In Belgium, the inclusion of a test kit doubled the likelihood to participate in CRC screening, compared to an invitation letter with the indication to collect the kit from the GP.

“In Belgium, the inclusion of a test kit doubled the likelihood to participate in CRC screening, compared to an invitation letter with the indication to collect the kit from the GP [28].”

A modest impact of including a test kit was detected in Italy (63.0% vs 56.8%).

“A modest impact was also detected in Italy (63.0%vs 56.8%) [28].”

A positive impact of establishing separate screening clinics was observed also in countries without national screening programmes.

“A positive impact was observed also in countries without national screening programmes [28,42].”