Perceived Obstacles of Colorectal Cancer Screening and Their Associated Factors among 10,078 Chinese Participants

PURPOSE to evaluate the proportion of self-referred screening participants having various psychological barriers and the factors associated with these barriers. METHODS A territory-wide bowel cancer screening centre sent an invitation via the media to all Hong Kong residents aged 50-70 years who were asymptomatic of CRC to join a free screening programme. Upon attendance they were requested to complete self-administered surveys on their perceived barriers of screening. Binary logistic regression analyses were used to evaluate the factors associated with these barriers. RESULTS From 10,078 consecutive screening participants (mean age 57.5 years; female 56.4%) completed the surveys between May 2008 to September 2012. There were high proportions who agreed or strongly agreed with the following barriers: financial difficulty (86.0%), limited service accessibility (58.2%), screening-induced bodily discomfort (55.2%), physical harm (44.4%), embarrassment (40.1%), apprehension (38.8%) and time constraints (13.9%). From regression models, older participants (aged ≥ 56) were less likely to have these barriers (Adjusted odds ratio [AOR] ranged from 0.738 to 0.952) but they encountered more difficulties to access to screening services (AOR ranged from 1.141 to 1.371). Female subjects were more likely to encounter most of these barriers (AOR ranged from 1.188 to 2.179). Participants who were uncertain of the necessity of CRC screening for people aged ≥ 50 were more likely to report these barriers (AOR ranged from 1.151 to 1.671). CONCLUSION The proportions of perceptual barriers of CRC screening were high among these participants. Those with these associated factors should receive more thorough explanation of the screening test procedures.