Endoscopy 2011; 43(12): 1059-1086
DOI: 10.1055/s-0031-1291430
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Participation in colorectal cancer screening trials after first-time invitation: a systematic review

C. Khalid-de Bakker
1   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre (MUMC), The Netherlands
,
D. Jonkers
1   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre (MUMC), The Netherlands
,
K. Smits
2   Department of Pathology, Maastricht University Medical Centre (MUMC), The Netherlands
,
I. Mesters
3   Department of Epidemiology, Maastricht University Medical Centre (MUMC), The Netherlands
,
A. Masclee
1   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre (MUMC), The Netherlands
,
R. Stockbrügger
1   Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre (MUMC), The Netherlands
› Author Affiliations
Further Information

Publication History

submitted: 31 March 2010

accepted after revision: 18 July 2011

Publication Date:
01 December 2011 (online)

Background and study aim: Colorectal cancer (CRC) screening is implemented by an increasing number of countries. Participation rates of screening programs influence the health benefit and cost – effectiveness of the applied method. The aim was to systematically review participation rate after first-time invitation for CRC screening with fecal occult blood test (FOBT), sigmoidoscopy, colonoscopy, and/or computed tomography (CT) colonography.

Methods: A systematic literature search was performed prior to October 1 2009. Prospective CRC screening studies of unselected populations reporting participation rates were included.

Results: After meta-analyses, overall participation rates were found to be 47 % for FOBT, 42 % for fecal immunologic tests (FITs), 35 % for sigmoidoscopy, 41 % for sigmoidoscopy combined with FIT/FOBT, 28 % for colonoscopy, and 22 % for CT colonography. Studies comparing screening methods showed higher participation rates for less invasive methods. Studies comparing invitation methods showed higher participation rates with general practitioner involvement, a more personalized recruitment approach, and reduction of barriers that discourage participation.

Conclusions: Knowledge of identified factors affecting CRC screening participation can be used to improve screening programs.

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