Viewpoints of the target population regarding barriers and facilitators of colorectal cancer screening in the Czech Republic
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摘要
BACKGROUND Public awareness of colorectal cancer(CRC) and uptake of CRC screening remain challenges. The viewpoints of the target population(asymptomatic individuals older than 50) regarding CRC screening information sources and the reasons for and against participation in CRC screening are not well known in the Czech Republic. This study aimed to acquire independent opinions from the target population independently on the health system.AIM To investigate the viewpoints of the target population regarding the source of information for and barriers and facilitators of CRC screening.METHODS A survey among relatives(aged 50 and older) of university students was conducted. Participants answered a questionnaire about sources of awareness regarding CRC screening, reasons for and against participation, and suggestions for improvements in CRC screening. The effect of certain variables on participation in CRC screening was analyzed.RESULTS Of 498 participants, 478(96%) respondents had some information about CRC screening and 375(75.3%) had participated in a CRC screening test. General practitioners(GPs)(n = 319, 64.1%) and traditional media(n = 166, 33.3%) were the most common information sources regarding CRC screening. A lack of interest or time and a fear of colonoscopy or positive results were reported as reasons for non-participation. Individuals aged > 60 years [adjusted odds ratio(aOR) = 2.30, 95% confidence interval(CI)(1.42-3.71), P = 0.001], females(aOR =1.95, 95%CI(1.26-3.01) P = 0.003), and relatives of CRC patients(aOR = 4.17,95%CI(1.82-9.58) P = 0.001) were more likely to participate in screening.Information regarding screening provided by physicians-GPs:(aOR = 8.11,95%CI(4.90-13.41), P < 0.001) and other specialists(aOR = 4.19, 95%CI(1.87-9.38),P = 0.001) increased participation in screening. Respondents suggested that providing better explanations regarding screening procedures and equipment for stool capturing could improve CRC screening uptake.CONCLUSION GPs and other specialists play crucial roles in the successful uptake of CRC screening. Reduction of the fear of colonoscopy and simple equipment for stool sampling might assist in improving the uptake of CRC screening.
BACKGROUND Public awareness of colorectal cancer(CRC) and uptake of CRC screening remain challenges. The viewpoints of the target population(asymptomatic individuals older than 50) regarding CRC screening information sources and the reasons for and against participation in CRC screening are not well known in the Czech Republic. This study aimed to acquire independent opinions from the target population independently on the health system.AIM To investigate the viewpoints of the target population regarding the source of information for and barriers and facilitators of CRC screening.METHODS A survey among relatives(aged 50 and older) of university students was conducted. Participants answered a questionnaire about sources of awareness regarding CRC screening, reasons for and against participation, and suggestions for improvements in CRC screening. The effect of certain variables on participation in CRC screening was analyzed.RESULTS Of 498 participants, 478(96%) respondents had some information about CRC screening and 375(75.3%) had participated in a CRC screening test. General practitioners(GPs)(n = 319, 64.1%) and traditional media(n = 166, 33.3%) were the most common information sources regarding CRC screening. A lack of interest or time and a fear of colonoscopy or positive results were reported as reasons for non-participation. Individuals aged > 60 years [adjusted odds ratio(aOR) = 2.30, 95% confidence interval(CI)(1.42-3.71), P = 0.001], females(aOR =1.95, 95%CI(1.26-3.01) P = 0.003), and relatives of CRC patients(aOR = 4.17,95%CI(1.82-9.58) P = 0.001) were more likely to participate in screening.Information regarding screening provided by physicians-GPs:(aOR = 8.11,95%CI(4.90-13.41), P < 0.001) and other specialists(aOR = 4.19, 95%CI(1.87-9.38),P = 0.001) increased participation in screening. Respondents suggested that providing better explanations regarding screening procedures and equipment for stool capturing could improve CRC screening uptake.CONCLUSION GPs and other specialists play crucial roles in the successful uptake of CRC screening. Reduction of the fear of colonoscopy and simple equipment for stool sampling might assist in improving the uptake of CRC screening.
BACKGROUND Public awareness of colorectal cancer(CRC) and uptake of CRC screening remain challenges. The viewpoints of the target population(asymptomatic individuals older than 50) regarding CRC screening information sources and the reasons for and against participation in CRC screening are not well known in the Czech Republic. This study aimed to acquire independent opinions from the target population independently on the health system.AIM To investigate the viewpoints of the target population regarding the source of information for and barriers and facilitators of CRC screening.METHODS A survey among relatives(aged 50 and older) of university students was conducted. Participants answered a questionnaire about sources of awareness regarding CRC screening, reasons for and against participation, and suggestions for improvements in CRC screening. The effect of certain variables on participation in CRC screening was analyzed.RESULTS Of 498 participants, 478(96%) respondents had some information about CRC screening and 375(75.3%) had participated in a CRC screening test. General practitioners(GPs)(n = 319, 64.1%) and traditional media(n = 166, 33.3%) were the most common information sources regarding CRC screening. A lack of interest or time and a fear of colonoscopy or positive results were reported as reasons for non-participation. Individuals aged > 60 years [adjusted odds ratio(aOR) = 2.30, 95% confidence interval(CI)(1.42-3.71), P = 0.001], females(aOR =1.95, 95%CI(1.26-3.01) P = 0.003), and relatives of CRC patients(aOR = 4.17,95%CI(1.82-9.58) P = 0.001) were more likely to participate in screening.Information regarding screening provided by physicians-GPs:(aOR = 8.11,95%CI(4.90-13.41), P < 0.001) and other specialists(aOR = 4.19, 95%CI(1.87-9.38),P = 0.001) increased participation in screening. Respondents suggested that providing better explanations regarding screening procedures and equipment for stool capturing could improve CRC screening uptake.CONCLUSION GPs and other specialists play crucial roles in the successful uptake of CRC screening. Reduction of the fear of colonoscopy and simple equipment for stool sampling might assist in improving the uptake of CRC screening.
引文
1 Dusek L,Muzik J,Kubasek M,Koptikova J,Zaloudik J,Vyzula R.Epidemiology of Malignant Tumours in the Czech Republic.[cited 21 May 2018].Masaryk University,Czech Republic.2007;Available from:http://portal.med.muni.cz/article-584-epidemiology-of-malignant-tumours-in-the-czech-republic.html
2 Ferlay J,Soerjomataram I,Dikshit R,Eser S,Mathers C,Rebelo M,Parkin DM,Forman D,Bray F.Cancer incidence and mortality worldwide:Sources,methods and major patterns in GLOBOCAN 2012.Int J Cancer 2015;136:E359-E386[PMID:25220842 DOI:10.1002/ijc.29210]
3 Shaukat A,Mongin SJ,Geisser MS,Lederle FA,Bond JH,Mandel JS,Church TR.Long-term mortality after screening for colorectal cancer.N Engl J Med 2013;369:1106-1114[PMID:24047060 DOI:10.1056/NEJMoa1300720]
4 Stock D,Paszat LF,Rabeneck L.Colorectal cancer mortality reduction is associated with having at least 1colonoscopy within the previous 10 years among a population-wide cohort of screening age.Gastrointest Endosc 2016;84:133-141[PMID:26769406 DOI:10.1016/j.gie.2015.12.035]
5 Inadomi JM.Screening for Colorectal Neoplasia.N Engl J Med 2017;376:149-156[PMID:28076720DOI:10.1056/NEJMcp1512286]
6 Edwards BK,Ward E,Kohler BA,Eheman C,Zauber AG,Anderson RN,Jemal A,Schymura MJ,Lansdorp-Vogelaar I,Seeff LC,van Ballegooijen M,Goede SL,Ries LA.Annual report to the nation on the status of cancer,1975-2006,featuring colorectal cancer trends and impact of interventions(risk factors,screening,and treatment)to reduce future rates.Cancer 2010;116:544-573[PMID:19998273 DOI:10.1002/cncr.24760]
7 Zauber AG.The impact of screening on colorectal cancer mortality and incidence:Has it really made a difference?Dig Dis Sci 2015;60:681-691[PMID:25740556 DOI:10.1007/s10620-015-3600-5]
8 Suchanek S,Majek O,Vojtechova G,Minarikova P,Rotnaglova B,Seifert B,Minarik M,Kozeny P,Dusek L,Zavoral M.Colorectal cancer prevention in the Czech Republic:Time trends in performance indicators and current situation after 10 years of screening.Eur J Cancer Prev 2014;23:18-26[PMID:24129196 DOI:10.1097/CEJ.0b013e328364f203]
9 Zavoral M,VojtěchováG,Májek O,Ngo O,Grega T,Seifert B,Du?ek L,Suchánek?.[Population colorectal cancer screening in the Czech Republic].Cas Lek Cesk 2016;155:7-12[PMID:26898786]
10 Du?ek L,Zavoral M,Majek O,Suchanek S,Muzik J,Pavlik T et al.Kolorektum.cz-Colorectal Cancer Screening Programme in the Czech Republic.[online,09 June 2018].Masaryk University,Brno,Czech Republic.2018;Available from:http://www.kolorektum.cz/index-en.php?pg=for-the-public--colorectal-cancer-screening--czech-republic
11 Ngo O,Bu?kováB,Suchánek?,Seifert B,Zavoral M,Du?ek L,Májek O.Participation of the Czech population in the Colorectal Cancer Screening Programme-trends and current situation.Gastroenterol Hepatol 2017;71:377-383[DOI:10.14735/amgh2017377]
12 European Colorectal Cancer Screening Guidelines Working Group.von Karsa L,Patnick J,Segnan N,Atkin W,Halloran S,Lansdorp-Vogelaar I,Malila N,Minozzi S,Moss S,Quirke P,Steele RJ,Vieth M,Aabakken L,Altenhofen L,Ancelle-Park R,Antoljak N,Anttila A,Armaroli P,Arrossi S,Austoker J,Banzi R,Bellisario C,Blom J,Brenner H,Bretthauer M,Camargo Cancela M,Costamagna G,Cuzick J,Dai M,Daniel J,Dekker E,Delicata N,Ducarroz S,Erfkamp H,Espinàs JA,Faivre J,Faulds Wood L,Flugelman A,Frkovic-Grazio S,Geller B,Giordano L,Grazzini G,Green J,Hamashima C,Herrmann C,Hewitson P,Hoff G,Holten I,Jover R,Kaminski MF,Kuipers EJ,Kurtinaitis J,Lambert R,Launoy G,Lee W,Leicester R,Leja M,Lieberman D,Lignini T,Lucas E,Lynge E,Mádai S,Marinho J,Mau?ec Zakotnik J,Minoli G,Monk C,Morais A,Muwonge R,Nadel M,Neamtiu L,Peris Tuser M,Pignone M,Pox C,Primic-Zakelj M,Psaila J,Rabeneck L,Ransohoff D,Rasmussen M,Regula J,Ren J,Rennert G,Rey J,Riddell RH,Risio M,Rodrigues V,Saito H,Sauvaget C,Scharpantgen A,Schmiegel W,Senore C,Siddiqi M,Sighoko D,Smith R,Smith S,Suchanek S,Suonio E,Tong W,T?rnberg S,Van Cutsem E,Vignatelli L,Villain P,Voti L,Watanabe H,Watson J,Winawer S,Young G,Zaksas V,Zappa M,Valori R.European guidelines for quality assurance in colorectal cancer screening and diagnosis:Overview and introduction to the full supplement publication.Endoscopy 2013;45:51-59[PMID:23212726 DOI:10.1055/s-0032-1325997]
13 Gesink D,Filsinger B,Mihic A,Norwood TA,Sarai Racey C,Perez D,Antal J,Ritvo P,Vernich L.Cancer screening barriers and facilitators for under and never screened populations:A mixed methods study.Cancer Epidemiol 2016;45:126-134[PMID:27810484 DOI:10.1016/j.canep.2016.10.015]
14 Král N,Seifert B,Suchánek?,Zavoral M,Májek O.[The populations attitudes to colorectal cancer screening in the Czech Republic].Epidemiol Mikrobiol Imunol 2015;64:41-46[PMID:25872995]
15 Calanzani N,Cavers D,Vojt G,Orbell S,Steele RJC,Brownlee L,Smith S,Patnick J,Weller D,Campbell C.Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable?A mixed-methods feasibility study in Scotland.BMJ Open 2017;7:e016307[PMID:29025829 DOI:10.1136/bmjopen-2017-016307]
16 Triantafillidis JK,Vagianos C,Gikas A,Korontzi M,Papalois A.Screening for colorectal cancer:The role of the primary care physician.Eur J Gastroenterol Hepatol 2017;29:e1-e7[PMID:27676092 DOI:10.1097/MEG.0000000000000759]
17 Carrasco-Garrido P,Hernandez-Barrera V,Lopez de Andres A,Jimenez-Trujillo I,Gallardo Pino C,Jimenez-Garc?a R.Awareness and uptake of colorectal,breast,cervical and prostate cancer screening tests in Spain.Eur J Public Health 2014;24:264-270[PMID:23813710 DOI:10.1093/eurpub/ckt089]
18 Costa AR,Silva S,Moura-Ferreira P,Villaverde-Cabral M,Santos O,Carmo ID,Barros H,Lunet N.Cancer screening in Portugal:Sex differences in prevalence,awareness of organized programmes and perception of benefits and adverse effects.Health Expect 2017;20:211-220[PMID:26914376 DOI:10.1111/hex.12450]
19 Michopoulos S,Manios E,Kourkoutas H,Argyriou K,Leonidakis G,Zampeli E,Stamatelopoulos K,Dimopoulos AM.Predictors of colorectal cancer screening awareness among people working in a hospital environment.Ann Gastroenterol 2017;30:315-321[PMID:28469362 DOI:10.20524/aog.2017.0127]
20 Bapuji SB,Lobchuk MM,McClement SE,Sisler JJ,Katz A,Martens P.Fecal occult blood testing instructions and impact on patient adherence.Cancer Epidemiol 2012;36:e258-e264[PMID:22504053DOI:10.1016/j.canep.2012.03.007]
21 van der Vlugt M,Grobbee EJ,Bossuyt PMM,Bos A,Bongers E,Spijker W,Kuipers EJ,LansdorpVogelaar I,Spaander MCW,Dekker E.Interval Colorectal Cancer Incidence Among Subjects Undergoing Multiple Rounds of Fecal Immunochemical Testing.Gastroenterology 2017;153:439-447.e2[PMID:28483499 DOI:10.1053/j.gastro.2017.05.004]
22 Suchánek?,Májek O,Zavoral M,Seifert B,Ngo O,Du?ek L.Results of the Czech National Colorectal Cancer Screening Programme-Colonoscopy Examinations.Klin Onkol 2014;27:98-105[DOI:10.14735/amko20142S98]
23 Ghevariya V,Duddempudi S,Ghevariya N,Reddy M,Anand S.Barriers to screening colonoscopy in an urban population:A study to help focus further efforts to attain full compliance.Int J Colorectal Dis 2013;28:1497-1503[PMID:23666513 DOI:10.1007/s00384-013-1708-7]
24 Adrián-de-Ganzo Z,Alarcón-Fernández O,Ramos L,Gimeno-García A,Alonso-Abreu I,Carrillo M,Quintero E.Uptake of Colon Capsule Endoscopy vs Colonoscopy for Screening Relatives of Patients With Colorectal Cancer.Clin Gastroenterol Hepatol 2015;13:2293-301.e1[PMID:26133904 DOI:10.1016/j.cgh.2015.06.032]
25 Kojecky V,Matous J,Keil R,Dastych M,Kroupa R,Zadorova Z,Varga M,Dolina J,Kment M,Hep A.A head-to-head comparison of 4-L polyethylene glycol and low-volume solutions before colonoscopy:Which is the best?A multicentre,randomized trial.Int J Colorectal Dis 2017;32:1763-1766[PMID:28944412 DOI:10.1007/s00384-017-2901-x]
26 Dumonceau JM,Riphaus A,Schreiber F,Vilmann P,Beilenhoff U,Aparicio JR,Vargo JJ,Manolaraki M,Wientjes C,Rácz I,Hassan C,Paspatis G.Non-anesthesiologist administration of propofol for gastrointestinal endoscopy:European Society of Gastrointestinal Endoscopy,European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline--Updated June 2015.Endoscopy 2015;47:1175-1189[PMID:26561915 DOI:10.1055/s-0034-1393414]
27 Bugajski M,Wieszczy P,Hoff G,Rupinski M,Regula J,Kaminski MF.Modifiable factors associated with patient-reported pain during and after screening colonoscopy.Gut 2018;67:1958-1964[PMID:28970289 DOI:10.1136/gutjnl-2017-313905]
28 Kahi CJ,Pohl H,Myers LJ,Mobarek D,Robertson DJ,Imperiale TF.Colonoscopy and Colorectal Cancer Mortality in the Veterans Affairs Health Care System:A Case-Control Study.Ann Intern Med2018;168:481-488[PMID:29532085 DOI:10.7326/M17-0723]
29 Falzone L,Scola L,ZanghìA,Biondi A,Di Cataldo A,Libra M,Candido S.Integrated analysis of colorectal cancer microRNA datasets:Identification of microRNAs associated with tumor development.Aging(Albany NY)2018;10:1000-1014[PMID:29779016 DOI:10.18632/aging.101444]
30 Chen FW,Sundaram V,Chew TA,Ladabaum U.Advanced-Stage Colorectal Cancer in Persons Younger Than 50 Years Not Associated With Longer Duration of Symptoms or Time to Diagnosis.Clin Gastroenterol Hepatol 2017;15:728-737.e3[PMID:27856366 DOI:10.1016/j.cgh.2016.10.038]
31 Dozois EJ,Boardman LA,Suwanthanma W,Limburg PJ,Cima RR,Bakken JL,Vierkant RA,Aakre JA,Larson DW.Young-onset colorectal cancer in patients with no known genetic predisposition:Can we increase early recognition and improve outcome?Medicine(Baltimore)2008;87:259-263[PMID:18794708 DOI:10.1097/MD.0b013e3181881354]
2 Ferlay J,Soerjomataram I,Dikshit R,Eser S,Mathers C,Rebelo M,Parkin DM,Forman D,Bray F.Cancer incidence and mortality worldwide:Sources,methods and major patterns in GLOBOCAN 2012.Int J Cancer 2015;136:E359-E386[PMID:25220842 DOI:10.1002/ijc.29210]
3 Shaukat A,Mongin SJ,Geisser MS,Lederle FA,Bond JH,Mandel JS,Church TR.Long-term mortality after screening for colorectal cancer.N Engl J Med 2013;369:1106-1114[PMID:24047060 DOI:10.1056/NEJMoa1300720]
4 Stock D,Paszat LF,Rabeneck L.Colorectal cancer mortality reduction is associated with having at least 1colonoscopy within the previous 10 years among a population-wide cohort of screening age.Gastrointest Endosc 2016;84:133-141[PMID:26769406 DOI:10.1016/j.gie.2015.12.035]
5 Inadomi JM.Screening for Colorectal Neoplasia.N Engl J Med 2017;376:149-156[PMID:28076720DOI:10.1056/NEJMcp1512286]
6 Edwards BK,Ward E,Kohler BA,Eheman C,Zauber AG,Anderson RN,Jemal A,Schymura MJ,Lansdorp-Vogelaar I,Seeff LC,van Ballegooijen M,Goede SL,Ries LA.Annual report to the nation on the status of cancer,1975-2006,featuring colorectal cancer trends and impact of interventions(risk factors,screening,and treatment)to reduce future rates.Cancer 2010;116:544-573[PMID:19998273 DOI:10.1002/cncr.24760]
7 Zauber AG.The impact of screening on colorectal cancer mortality and incidence:Has it really made a difference?Dig Dis Sci 2015;60:681-691[PMID:25740556 DOI:10.1007/s10620-015-3600-5]
8 Suchanek S,Majek O,Vojtechova G,Minarikova P,Rotnaglova B,Seifert B,Minarik M,Kozeny P,Dusek L,Zavoral M.Colorectal cancer prevention in the Czech Republic:Time trends in performance indicators and current situation after 10 years of screening.Eur J Cancer Prev 2014;23:18-26[PMID:24129196 DOI:10.1097/CEJ.0b013e328364f203]
9 Zavoral M,VojtěchováG,Májek O,Ngo O,Grega T,Seifert B,Du?ek L,Suchánek?.[Population colorectal cancer screening in the Czech Republic].Cas Lek Cesk 2016;155:7-12[PMID:26898786]
10 Du?ek L,Zavoral M,Majek O,Suchanek S,Muzik J,Pavlik T et al.Kolorektum.cz-Colorectal Cancer Screening Programme in the Czech Republic.[online,09 June 2018].Masaryk University,Brno,Czech Republic.2018;Available from:http://www.kolorektum.cz/index-en.php?pg=for-the-public--colorectal-cancer-screening--czech-republic
11 Ngo O,Bu?kováB,Suchánek?,Seifert B,Zavoral M,Du?ek L,Májek O.Participation of the Czech population in the Colorectal Cancer Screening Programme-trends and current situation.Gastroenterol Hepatol 2017;71:377-383[DOI:10.14735/amgh2017377]
12 European Colorectal Cancer Screening Guidelines Working Group.von Karsa L,Patnick J,Segnan N,Atkin W,Halloran S,Lansdorp-Vogelaar I,Malila N,Minozzi S,Moss S,Quirke P,Steele RJ,Vieth M,Aabakken L,Altenhofen L,Ancelle-Park R,Antoljak N,Anttila A,Armaroli P,Arrossi S,Austoker J,Banzi R,Bellisario C,Blom J,Brenner H,Bretthauer M,Camargo Cancela M,Costamagna G,Cuzick J,Dai M,Daniel J,Dekker E,Delicata N,Ducarroz S,Erfkamp H,Espinàs JA,Faivre J,Faulds Wood L,Flugelman A,Frkovic-Grazio S,Geller B,Giordano L,Grazzini G,Green J,Hamashima C,Herrmann C,Hewitson P,Hoff G,Holten I,Jover R,Kaminski MF,Kuipers EJ,Kurtinaitis J,Lambert R,Launoy G,Lee W,Leicester R,Leja M,Lieberman D,Lignini T,Lucas E,Lynge E,Mádai S,Marinho J,Mau?ec Zakotnik J,Minoli G,Monk C,Morais A,Muwonge R,Nadel M,Neamtiu L,Peris Tuser M,Pignone M,Pox C,Primic-Zakelj M,Psaila J,Rabeneck L,Ransohoff D,Rasmussen M,Regula J,Ren J,Rennert G,Rey J,Riddell RH,Risio M,Rodrigues V,Saito H,Sauvaget C,Scharpantgen A,Schmiegel W,Senore C,Siddiqi M,Sighoko D,Smith R,Smith S,Suchanek S,Suonio E,Tong W,T?rnberg S,Van Cutsem E,Vignatelli L,Villain P,Voti L,Watanabe H,Watson J,Winawer S,Young G,Zaksas V,Zappa M,Valori R.European guidelines for quality assurance in colorectal cancer screening and diagnosis:Overview and introduction to the full supplement publication.Endoscopy 2013;45:51-59[PMID:23212726 DOI:10.1055/s-0032-1325997]
13 Gesink D,Filsinger B,Mihic A,Norwood TA,Sarai Racey C,Perez D,Antal J,Ritvo P,Vernich L.Cancer screening barriers and facilitators for under and never screened populations:A mixed methods study.Cancer Epidemiol 2016;45:126-134[PMID:27810484 DOI:10.1016/j.canep.2016.10.015]
14 Král N,Seifert B,Suchánek?,Zavoral M,Májek O.[The populations attitudes to colorectal cancer screening in the Czech Republic].Epidemiol Mikrobiol Imunol 2015;64:41-46[PMID:25872995]
15 Calanzani N,Cavers D,Vojt G,Orbell S,Steele RJC,Brownlee L,Smith S,Patnick J,Weller D,Campbell C.Is an opportunistic primary care-based intervention for non-responders to bowel screening feasible and acceptable?A mixed-methods feasibility study in Scotland.BMJ Open 2017;7:e016307[PMID:29025829 DOI:10.1136/bmjopen-2017-016307]
16 Triantafillidis JK,Vagianos C,Gikas A,Korontzi M,Papalois A.Screening for colorectal cancer:The role of the primary care physician.Eur J Gastroenterol Hepatol 2017;29:e1-e7[PMID:27676092 DOI:10.1097/MEG.0000000000000759]
17 Carrasco-Garrido P,Hernandez-Barrera V,Lopez de Andres A,Jimenez-Trujillo I,Gallardo Pino C,Jimenez-Garc?a R.Awareness and uptake of colorectal,breast,cervical and prostate cancer screening tests in Spain.Eur J Public Health 2014;24:264-270[PMID:23813710 DOI:10.1093/eurpub/ckt089]
18 Costa AR,Silva S,Moura-Ferreira P,Villaverde-Cabral M,Santos O,Carmo ID,Barros H,Lunet N.Cancer screening in Portugal:Sex differences in prevalence,awareness of organized programmes and perception of benefits and adverse effects.Health Expect 2017;20:211-220[PMID:26914376 DOI:10.1111/hex.12450]
19 Michopoulos S,Manios E,Kourkoutas H,Argyriou K,Leonidakis G,Zampeli E,Stamatelopoulos K,Dimopoulos AM.Predictors of colorectal cancer screening awareness among people working in a hospital environment.Ann Gastroenterol 2017;30:315-321[PMID:28469362 DOI:10.20524/aog.2017.0127]
20 Bapuji SB,Lobchuk MM,McClement SE,Sisler JJ,Katz A,Martens P.Fecal occult blood testing instructions and impact on patient adherence.Cancer Epidemiol 2012;36:e258-e264[PMID:22504053DOI:10.1016/j.canep.2012.03.007]
21 van der Vlugt M,Grobbee EJ,Bossuyt PMM,Bos A,Bongers E,Spijker W,Kuipers EJ,LansdorpVogelaar I,Spaander MCW,Dekker E.Interval Colorectal Cancer Incidence Among Subjects Undergoing Multiple Rounds of Fecal Immunochemical Testing.Gastroenterology 2017;153:439-447.e2[PMID:28483499 DOI:10.1053/j.gastro.2017.05.004]
22 Suchánek?,Májek O,Zavoral M,Seifert B,Ngo O,Du?ek L.Results of the Czech National Colorectal Cancer Screening Programme-Colonoscopy Examinations.Klin Onkol 2014;27:98-105[DOI:10.14735/amko20142S98]
23 Ghevariya V,Duddempudi S,Ghevariya N,Reddy M,Anand S.Barriers to screening colonoscopy in an urban population:A study to help focus further efforts to attain full compliance.Int J Colorectal Dis 2013;28:1497-1503[PMID:23666513 DOI:10.1007/s00384-013-1708-7]
24 Adrián-de-Ganzo Z,Alarcón-Fernández O,Ramos L,Gimeno-García A,Alonso-Abreu I,Carrillo M,Quintero E.Uptake of Colon Capsule Endoscopy vs Colonoscopy for Screening Relatives of Patients With Colorectal Cancer.Clin Gastroenterol Hepatol 2015;13:2293-301.e1[PMID:26133904 DOI:10.1016/j.cgh.2015.06.032]
25 Kojecky V,Matous J,Keil R,Dastych M,Kroupa R,Zadorova Z,Varga M,Dolina J,Kment M,Hep A.A head-to-head comparison of 4-L polyethylene glycol and low-volume solutions before colonoscopy:Which is the best?A multicentre,randomized trial.Int J Colorectal Dis 2017;32:1763-1766[PMID:28944412 DOI:10.1007/s00384-017-2901-x]
26 Dumonceau JM,Riphaus A,Schreiber F,Vilmann P,Beilenhoff U,Aparicio JR,Vargo JJ,Manolaraki M,Wientjes C,Rácz I,Hassan C,Paspatis G.Non-anesthesiologist administration of propofol for gastrointestinal endoscopy:European Society of Gastrointestinal Endoscopy,European Society of Gastroenterology and Endoscopy Nurses and Associates Guideline--Updated June 2015.Endoscopy 2015;47:1175-1189[PMID:26561915 DOI:10.1055/s-0034-1393414]
27 Bugajski M,Wieszczy P,Hoff G,Rupinski M,Regula J,Kaminski MF.Modifiable factors associated with patient-reported pain during and after screening colonoscopy.Gut 2018;67:1958-1964[PMID:28970289 DOI:10.1136/gutjnl-2017-313905]
28 Kahi CJ,Pohl H,Myers LJ,Mobarek D,Robertson DJ,Imperiale TF.Colonoscopy and Colorectal Cancer Mortality in the Veterans Affairs Health Care System:A Case-Control Study.Ann Intern Med2018;168:481-488[PMID:29532085 DOI:10.7326/M17-0723]
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