1699MO - Intervening factors for participation and non-participation in colorectal cancer screening in Spain

Background

The Spanish Ministry of Health introduced a population-based colorectal screening program within its common services portfolio in 2014. The program targeted adults from 50 to 69 years. They receive a personal invitation letter asking them to perform the fecal occult blood test (FOBT). To achieve public health benefits on incidence, mortality, and cost-effectiveness from this screening program 65% participation in the program is needed¹. Although participation rates have been improved since 2014, there is still room from improvement as only 56% of the Spanish regions reach the participation threshold². In this study, we examined attitudinal and social factors impacting on participation in the target population.

Methods

A survey of the target population of the screening program was conducted using a national online panel representative of the Spanish population. A representative program's target population sample, with a size of 5131 valid responses, was obtained. The data collection was conducted from June to July 2022. The data was analyzed using a descriptive analysis for the entire sample as well as the logistic regression technique.

Results

We found that 62.5% of the target population in Spain has had the FOBT effectively carried out, 72.5% have received the information letter to participate in the screening program and 86.8% were familiar with the test. Furthermore, receipt of the information letter (OR 7.35, p<0.01) and knowledge of the FOBT (OR 6.32, p<0.01) are the main variables that increase the probability of the actual completion of the test. Other variables with a high contribution are the frequency with which one visits a doctor (OR 1.71, p<0.01) and the fact of belonging to higher age brackets (OR 1.52, p<0.01).

Conclusions

Alongside the universal implementation of the invitation to the program, researchers must work with attitudinal variables which act as barriers to the population’s participation – such as prior knowledge of the test or the normalization of regular visits to a doctor – if we hope to achieve truly equal access to the screening program.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Asociación Española Contra el Cáncer.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.