Barriers to Colorectal Cancer Screening in a Primary Care Setting in Turkey

• Published in: Journal of community health Vol. 42; no. 1; pp. 101 - 108
• Main Authors: Sahin, Mustafa Kursat, Aker, Servet, Arslan, Hatice Nilden
• Format: Journal Article
• Language: English
• Published: New York Springer Science + Business Media 01.02.2017; Springer US; Springer Nature B.V
• Subjects: Adult; Aged; Barriers; Cancer; Colonoscopy; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - epidemiology; Communicable Diseases; Community and Environmental Psychology; Community Relations; Early Detection of Cancer - utilization; Ethics; Family (Sociological Unit); Female; Females; Guidelines; Health Knowledge, Attitudes, Practice; Health Promotion and Disease Prevention; Health Services; Health Services Accessibility - organization & administration; Health Services Accessibility - statistics & numerical data; Humans; Knowledge Level; Male; Males; Medical screening; Medicine; Medicine & Public Health; Middle Aged; Occult Blood; ORIGINAL PAPER; Patients; Physicians; Primary care; Primary Health Care; Primary Health Care - organization & administration; Primary Health Care - statistics & numerical data; Public Health; Questionnaires; Referral; Screening Tests; Statistical Analysis; Surveys and Questionnaires; Test Results; Turkey; Turkey; MED, Turkey; Fecal occult blood test; Primary health care; Barriers; Colonoscopy; Colorectal cancer; Cancer screening
• ISSN: 0094-5145; 1573-3610; 1573-3610
• DOI: 10.1007/s10900-016-0235-1

Colorectal cancer (CRC) is the third most common form of cancer in men worldwide and the second most common in women. The purpose of this study was to determine both barriers established by primary health care providers (PHCPs) and barriers perceived by them and to produce solutions for achieving the desired results. A four-part questionnaire was administered to family physicians (FPs) and family health personnels (FHPs) in Samsun, Turkey on 01–15 May, 2016. Sixty-six percent of PHCPs were contacted. Data were evaluated as numbers and percentages, and statistical significance was analyzed using the Chi square and t tests. 478 PHCPs participated; 49.4 % were FPs and 50.6 % FHPs. Of the participants, 86.6 % stated that they performed CRC screening on patients. The level of participants knowing that screening should start at age 50 and conclude at age 70 was 49.7 %. The level of subjects requesting the fecal occult blood test (FOBT) at the correct intervals was 29.7 %, but only 6.9 % recommended colonoscopy at the correct intervals. Additionally, 18.2 % of subjects knew that the test used is immunochemical FOBT, and 60.5 % reported not using reminders. PHCPs’low levels of knowledge, awareness and advice compatible with guidelines concerning CRC screening may represent an obstacle to such screening. Barriers perceived by PHCPs include patients’ inability to access definite medical information, deficiencies in the reminder system and patients’ lack of interest in CRC screening. Additions to the screening program will be useful in overcoming barriers.