Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening

作者：Gladys N Honein-AbouHaidar, Monika Kastner, Vincent Vuong, Laure Perrier, Corinne Daly, Linda Rabeneck, Sharon Elizabeth Straus, Nancy Noel Baxter · 发表于：Cancer Epidemiology Biomarkers & Prevention · 年份：2016 · DOI：10.1158/1055-9965.epi-15-0990 · 被引用次数：306 · 研究领域：Colorectal Cancer Screening and Detection、Global Cancer Incidence and Screening、Meta-analysis and systematic reviews

Screening reduces the incidence, morbidity, and mortality of colorectal cancer, yet participation tends to be low. We undertook a systematic review and meta-study synthesis of qualitative studies to identify facilitators and barriers to colorectal cancer screening participation. We searched major bibliographic databases for records published in all languages from inception to February 2015. Included primary studies that elicited views and perceptions towards colorectal cancer screening were appraised for relevance and quality. We used a two-stage synthesis to create an interpretation of colorectal cancer screening decisions grounded in primary studies; a thematic analysis to group themes and systematically compare studies and a meta-synthesis to generate an expanded theory of colorectal cancer screening participation. Ninety-four studies were included. The decision to participate in colorectal cancer screening depended on an individual's awareness of colorectal cancer screening. Awareness affected views of cancer, attitudes towards colorectal cancer screening modalities, and motivation for screening. Factors mediating awareness included public education to address misconceptions, primary care physician efforts to recommend screening, and the influence of friends and family. Specific barriers to participation in populations with lower participation rates included language barriers, logistical challenges to attending screening tests, and cultural beliefs. This study identifies ...