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The population’s attitudes to colorectal cancer screening in the Czech Republic


Authors: N. Král 1;  B. Seifert 1;  Š. Suchánek 2;  M. Zavoral 2;  O. Májek 3
Authors‘ workplace: Univerzita Karlova, 1. LF, Ústav všeobecného lékařství, Praha 1;  Univerzita Karlova, 1. LF, Ústřední vojenská nemocnice, Praha 2;  Masarykova univerzita, Institut biostatistiky a analýz, Brno 3
Published in: Epidemiol. Mikrobiol. Imunol. 64, 2015, č. 1, s. 41-46
Category: Review articles, original papers, case report

Overview

Background:
The mortality of colorectal cancer (CRC) is significant worldwide. There is good evidence for benefits of the CRC screening in mortality reduction. Since 2009, the population of the Czech Republic have had two CRC screening options from which to choose: a faecal occult blood test (FOBT) at the age of 50 to be repeated every two years or primary screening colonoscopy (PSC) at the age of 55. General practitioners play a crucial role in the CRC screening programme. The CRC screening adherence of the Czech population is poor and does not exceed 25%.

Material and Methods:
The aims of the study were to analyse the reasons behind the low CRC screening adherence of the Czech population, to classify the population’s attitudes, and to identify the barriers. A questionnaire survey was conducted in a Czech energy company with 13,000 employees in 2011–2012. The questionnaire was administered electronically by e-mail or directly at the workplace.

Results:
The questionnaire response rate was 31.3% (4070). The pool of respondents consisted of 2804 (68.9%) females and 1266 (31.1%) males. Of the respondents, 1345 (33.1%) were aged over 50 years (73.5% women and 26.5% men). Of the cohort aged over 50, 68.65% of women and 63.2% of men took a FOBT. Ten percent of respondents aged over 50 years have never heard of CRC screening and 32.8% of this age category have never participated in CRC screening. The main reasons for not taking a FOBT were feeling well and having no health problems (38.8%) or FOBT not offered the by the general practitioner (27.8%). Other reasons were no time to do so, fear of the result, unsure of the procedure, unawareness of what FOBT is, or uncomfortable about the test procedure. On the other hand, 8.37% of the participants aged between 15 and 39 years and 20.7% of those aged between 40 and 49 years have already taken a FOBT. Overall, 15.4% of respondents prefer the new alternative, PSC, as the CRC screening option. Significant differences in CRC screening adherence are seen between administrative regions of the Czech Republic and between education levels.

Conclusions:
From the results, it follows that a considerable proportion of the population of the Czech Republic do not understand the principle of CRC screening and its methods. Enough room has been left to promote education on CRC screening for both the public and general practitioners. On the other hand, a large part of proactive individuals participate in CRC screening before the age of 50.

Keywords:
colorectal cancer – screening – general practitioner – population – patient


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