Approaching the Hard-to-Reach in Organized Colorectal Cancer Screening: an Overview of Individual, Provider and System Level Coping Strategies

Jason Liwen Huang; Yuan Fang; Miaoyin Liang; Shannon TS Li; Simpson KC Ng; Zero SN Hui; Jessica Ching; Harry Haoxiang Wang; Martin Chi Sang Wong

doi:10.3934/publichealth.2017.3.289

AIMS Public Health , 2017, 4(3): 289-300. doi: 10.3934/publichealth.2017.3.289. Review

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Approaching the Hard-to-Reach in Organized Colorectal Cancer Screening: an Overview of Individual, Provider and System Level Coping Strategies

Jason Liwen Huang, Yuan Fang, Miaoyin Liang, Shannon TS Li, Simpson KC Ng, Zero SN Hui, Jessica Ching, Harry Haoxiang Wang, Martin Chi Sang Wong

1 JC School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
2 JC bowel cancer education center, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong SAR, China
3 School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
4 General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, UK
5 Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong
6 State Key Laboratory of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong

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Background: Despite the proven effectiveness of colorectal cancer (CRC) screening on reduction of CRC mortality, the uptake of CRC screening remains low. Participation rate is one of determinants for the success of organized population-based screening program. This review aims to identify those who are hard-to-reach, and summarize the strategies to increase their screening rate from individual, provider and system levels. Methods: A systematic search of electronic English databases was conducted on the factors and strategies of uptake in CRC screening for the hard-to-reach population up to May 2017. Discussion: The coverage rate and participation rate are two indexes to identify the hard-to-reach population in organized CRC screening program. However, the homeless, new immigrants, people with severe mental illness, the jail intimates, and people with characteristics including lower education levels and/or low socioeconomic status, living in rural/remote areas, without insurance, and racial minorities are usually recognized as hard-to-reach populations. For them, organized screening programs offer a better coverage, while novel invitation approaches for eligible individuals and multiple strategies from primary care physicians are still needed to enhance screening rates among subjects who are hard-to-reach. Suggestions implied the effectiveness of interventions at the system level, including linkages to general practice; use of decision making tools; enlisting supports from coalition; and the continuum from screening to diagnosis and treatment. Conclusion: Organized CRC screening offers a system access to approach the hard-to-reach populations. To increase their uptake, multiple and novel strategies from individual, provider and system levels should be applied. For policymakers, public healthcare providers and community stakeholders, it is a test to tailor their potential needs and increase their participation rates through continuous efforts to eliminate disparities and inequity in CRC screening service.

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Keywords: colorectal cancer; screening; participation; uptake; hard-to-reach

Citation: Jason Liwen Huang, Yuan Fang, Miaoyin Liang, Shannon TS Li, Simpson KC Ng, Zero SN Hui, Jessica Ching, Harry Haoxiang Wang, Martin Chi Sang Wong. Approaching the Hard-to-Reach in Organized Colorectal Cancer Screening: an Overview of Individual, Provider and System Level Coping Strategies. AIMS Public Health , 2017, 4(3): 289-300. doi: 10.3934/publichealth.2017.3.289

References:

1. Ladabaum U (2016) Colorectal cancer screening. In: Podolsky DK, Camilleri M, Fitz JG, et al., eds. Yamada's textbook of gastroenterology. Sixth Edition ed. John Wiley & Sons, Ltd., 1608-1628.
2. Australian Institute Health Welfare. Cancer in australia 2017. 2017; CAN 100.
3. Sano Y, Byeon J, Li X, et al. (2016) Colorectal cancer screening of the general population in east asia. Dig Endosc 28: 243-249.
4. Schreuders EH, Ruco A, Rabeneck L, et al. (2015) Colorectal cancer screening: A global overview of existing programmes. Gut 64: 1637-1649.
5. Koo JH, Leong RWL, Ching J, et al. (2012) Knowledge of, attitudes toward, and barriers to participation of colorectal cancer screening tests in the asia-pacific region: A multicenter study. Gastrointest Endosc 76: 126-135.
6. Essink-Bot M, Dekker E (2016) Equal access to colorectal cancer screening. Lancet 387: 724-726.
7. Moss S, Ancelle-Park R, Brenner H (2010) Evaluation and interpretation of screening outcomes. In: European guidelines for quality assurance in colorectal cancer screening and diagnosis. 71-102.
8. Levin TR (2016) Colorectal cancer screening: 80% by 2018. Colonoscopists simply cannot do it alone. Gastrointest Endosc 83: 552-554.
9. Lambert EY (1990) The collection and interpretation of data from hidden populations.washington, DC: United states national institute on drug abuse. Bur Justice Stat.
10. Bonevski B, Randell M, Paul C, et al. (2014) Reaching the hard-to-reach: A systematic review of strategies for improving health and medical research with socially disadvantaged groups. BMC Med Res Methodol 14: 1.
11. Levin T, Rabeneck L, Burroughs A, et al. (2010) Colorectal cancer: Population screening and surveillance. In: Evidence-based gastroenterology and hepatolog. Chichester: John Wiley & Sons, Ltd., 311-323.
12. Ouellette-Kuntz H, Coo H, Cobigo V, et al. (2015) Uptake of colorectal cancer screening among ontarians with intellectual and developmental disabilities. PloS one 10: e0118023.
13. Chau S, Chin M, Chang J, et al. (2002) Cancer risk behaviors and screening rates among homeless adults in Los Angeles County. Cancer Epidemiol Biomarkers Prev 11: 431-438.
14. Asgary R, Garland V, Jakubowski A, et al. (2014) Colorectal cancer screening among the homeless population of new york city shelter- based clinics. (report). Am J Public Health 104: 1307.
15. Binswanger IA, White MC, Perez-Stable EJ, et al. (2005) Cancer screening among jail inmates: Frequency, knowledge, and willingness. Am J Public Health 95: 1781-1787.
16. Moss SM, Campbell C, Melia J, et al. (2012) Performance measures in three rounds of the english bowel cancer screening pilot. Gut 61: 101-107.
17. Mo PKH, Mak WWS, Chong ESK, et al. (2014) The prevalence and factors for cancer screening behavior among people with severe mental illness in hong kong. PLoS ONE 9.
18. Vernon SW (1997) Participation in colorectal cancer screening: A review. J Natl Cancer Inst 89: 1406-1422.
19. Day S, Dort PV, Tay KS (2010) Improving participation in cancer screening programs: A review of social cognitive models, factors affecting participation, and strategies to improve participation.
20. Gupta S, Sussman DA, Doubeni CA, et al. (2014) Challenges and possible solutions to colorectal cancer screening for the underserved. J Natl Cancer Inst 106.
21. Wools A, Dapper EA, Leeuw JRJD. (2016) Colorectal cancer screening participation: A systematic review. Eur J Public Health 26: 158-168.
22. Martini A, Javanparast S, Ward PR, et al. (2011) Colorectal cancer screening in rural and remote areas: Analysis of the national bowel cancer screening program data for south Australia. Rural Remote Health 11: 1648.
23. El-Haddad B, Dong F, Kallail KJ, et al. (2015) Association of marital status and colorectal cancer screening participation in the USA. Colorectal Disease 17: O108-O114.
24. Artama M, Heinavaara S, Sarkeala T, et al. (2016) Determinants of non-participation in a mass screening program for colorectal cancer in Finland. Acta Oncol 55: 870-874.
25. Blanks RG, Benson VS, Alison R, et al. (2015) Nationwide bowel cancer screening programme in england: Cohort study of lifestyle factors affecting participation and outcomes in women. Br J Cancer 112: 1562-1567.
26. Bussière C, Sicsic J, Pelletier-Fleury N (2014) The effects of obesity and mobility disability in access to breast and cervical cancer screening in france: Results from the national health and disability survey. PloS One 9: e104901.
27. Lofters AK, Gozdyra P, Lobb R (2013) Using geographic methods to inform cancer screening interventions for south Asians in ontario, canada. BMC Public Health 13: 1.
28. Eisinger F, Cals L, Calazel-Benque A, et al. (2008) Impact of organised programs on colorectal cancer screening. BMC Cancer 8: 1.
29. Rice N, Smith PC (2001) Ethics and geographical equity in health care. J Med Ethics 27: 256-261.
30. Senore C, Inadomi J, Segnan N, et al. (2015) Optimising colorectal cancer screening acceptance: A review. Gut 64: 1158-1177.
31. Tinmouth JM, Patel J, Austin PC, et al. (2013) Increasing participation in colorectal cancer screening: Results from a randomized trial of directly mailed FOBT kits in a hard to reach population. Gastroenterology 144: S46.
32. Marquez E, Wang J, Colditz G, et al. (2016) 43 video-based intervention to improve colorectal cancer screening in underserved populations. Gastroenterology 150: S15.
33. Briant KJ, Espinoza N, Galvan A, et al. (2015) An innovative strategy to reach the underserved for colorectal cancer screening. J Cancer Educ 30: 237-243.
34. Gupta S, Halm EA, Rockey DC, et al. (2013) Comparative effectiveness of fecal immunochemical test outreach, colonoscopy outreach, and usual care for boosting colorectal cancer screening among the underserved: A randomized clinical trial. JAMA Intern Med 173: 1725-1732.
35. Leyva B, Nguyen A, Allen J, et al. (2015) Is religiosity associated with cancer screening? results from a national survey. J Relig Healt 54: 998-1013.
36. Ma GX (2015) An evidence-based colorectal cancer screening intervention for underserved Korean Americans.
37. Sung JJY, Choi SYP, Chan FKL, et al. (2008) Obstacles to colorectal cancer screening in chinese: A study based on the health belief model. Am J Gastroenterol 103: 974-981.
38. Triantafillidis JK, Vagianos C, Gikas A, et al. (2017) Screening for colorectal cancer: The role of the primary care physician. Eur J Gastroenterol Hepatol 29: e1-e7.
39. Emery JD, Shaw K, Williams B, et al. (2014) The role of primary care in early detection and follow-up of cancer. Nat Rev Clin Oncol 11: 38-48.
40. Cole S, Young G, Byrne D, et al. (2002) Participation in screening for colorectal cancer based on a faecal occult blood test is improved by endorsement by the primary care practitioner. J Med Screen 9: 147-152.
41. Klabunde CN, Frame PS, Meadow A, et al. (2003) A national survey of primary care physicians' colorectal cancer screening recommendations and practices. Prev Med 36: 352-362.
42. Şahin MK, Aker S (2016) Family physicians' knowledge, attitudes, and practices toward colorectal cancer screening. J Cancer Educ 1-6.
43. Benito L, García M, Binefa G, et al. (2016) Cross-sectional survey on awareness of colorectal cancer and a screening programme for primary health care professionals in catalonia, spain. Eur J cancer Care 25: 992-1004.
44. Baxter NN, Sutradhar R, Li Q, et al. (2017) Do primary care provider strategies improve patient participation in colorectal cancer screening? Am J Gastroenterol 112: 622.
45. Geng Z, Gupta S (2013) Mo1097 interventions to increase colorectal cancer screening among underserved populations: A systematic review. Gastroenterology 5: S576.
46. Cole H, Ravenell J, Schoenthaler A, et al. (2014) Community-based settings and sampling strategies: Implications for reducing racial health disparities among black men, new york city, 2010–2013. Prev Chronic Dis 11: 543-553.
47. Levin TR, Jamieson L, Burley DA, et al. (2011) Organized colorectal cancer screening in integrated health care systems. Epidemiol Rev 33: 101-110.
48. Senore C, Armaroli P, Silvani M, et al. (2010) Comparing different strategies for colorectal cancer screening in italy: Predictors of patients participation. Am J Gastroenterol 105: 188-198.
49. Palmer CK, Thomas MC, Von Wagner C, et al. (2014) Reasons for non-uptake and subsequent participation in the NHS bowel cancer screening programme: A qualitative study. Br J Cancer 110: 1705-1711.
50. Hall NJ, Rubin GP, Dobson C, et al. (2015) Attitudes and beliefs of non-participants in a population-based screening programme for colorectal cancer. Health Expect 18: 1645-1657.
51. Essink-Bot ML, Dekker E, Timmermans DRM, et al. (2016) Knowledge and informed decision-making about population-based colorectal cancer screening participation in groups with low and adequate health literacy. Gastroenterol Res Pract 2016: 1-8.
52. Itzkowitz SH, Winawer SJ, Krauskopf M, et al. (2016) New york citywide colon cancer control coalition: A public health effort to increase colon cancer screening and address health disparities. Cancer 122: 269-277.
53. Stimpson JP, Pagán JA, Chen L (2012) Reducing racial and ethnic disparities in colorectal cancer screening is likely to require more than access to care. Health Affairs 31: 2747-2754.
54. Boehm JE, Rohan EA, Preissle J, et al. (2013) Recruiting patients into the CDC's colorectal cancer screening demonstration program. Cancer 119: 2914-2925.

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Copyright Info: 2017, Martin Chi Sang Wong, et al., licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

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