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Factors affecting compliance with confirmatory colonoscopy after a positive fecal immunochemical test in a national colorectal screening program
Author(s) -
Cheng ShaoYi,
Li MingChieh,
Chia ShuLi,
Huang KuoChin,
Chiu TaiYuan,
Chan DingCheng,
Chiu HanMo
Publication year - 2018
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.31145
Subject(s) - medicine , health belief model , odds ratio , confidence interval , colonoscopy , logistic regression , population , demography , confirmatory factor analysis , cross sectional study , multivariate analysis , colorectal cancer , public health , structural equation modeling , health education , environmental health , cancer , pathology , statistics , mathematics , sociology
BACKGROUND Screening with the fecal immunochemical test (FIT) is effective in reducing deaths from colorectal cancer (CRC). Since 2004, biennial FIT screening has been available to a target population in Taiwan as a national screening program. The objective of the current study was to identify the factors that influence willingness to undergo a confirmatory colonoscopy after a positive FIT, because related references in the published literature were scarce. METHODS A semistructured questionnaire was based on the Health Belief Model (HBM) and a literature review. A stratified, random sampling method was used to recruit participants who had a positive FIT from all cities/counties in Taiwan. Cross‐sectional, computer‐assisted telephone interviews were conducted in 2012, and the results were analyzed using a logistic regression model that took into account population demographics, core content of the HBM, and HBM‐modifying variables. RESULTS In total, 2807 respondents were included in the analysis. The completion rate was 50%. Multivariate analyses revealed that higher perceived threat (adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 1.31‐2.01), higher cues for action (aOR, 2.18; 95% CI, 1.68‐1.82), lower perceived barriers (aOR, 0.42; 95% CI, 0.34‐0.42) and higher health behavior scores (aOR, 1.30; 95% CI, 1.05‐1.60) were associated with a greater willingness to participate in confirmatory colonoscopy. Participants who were older (aOR, 0.74; 95% CI, 0.55‐0.98) or unmarried (aOR, 0.72; 95% CI, 0.56‐0.92) were less likely to participate in verification. CONCLUSIONS The government could improve the screening rate by training case managers to assist in following patients until they complete colonoscopy, subsidizing sedated colonoscopies, and providing health education not only to the general public but also to physicians. Cancer 2018;124:907‐15 . © 2017 American Cancer Society .