Keywords: rural medicine, screening, colorectal cancer
Background:
Colorectal cancer (CRC) is a significant global health burden, ranking as the third most common cancer worldwide and the fourth leading cause of cancer-related deaths. Despite advances in screening and treatment, CRC incidence and mortality rates remain disproportionately high in rural and remote areas compared to urban regions.
Aim of the study:
The aim of this retrospective study was to assess the effectiveness of CRC screening in a rural setting, specifically focusing on identifying disparities between patients who declined colonoscopy after a positive fecal immunochemical test (FIT).
Methodology:
This retrospective study analyzed data from enrolled cases for CRC screening conducted in Sadova, focusing on the disparities between patients who refused colonoscopy after a FIT and those diagnosed with CRC. The study utilized existing records from the colorectal cancer screening program in Sadova, including patient demographics, FIT results, colonoscopy referral, diagnostic outcomes, and follow-up information. Data were collected from medical records, screening registries, and administrative databases.
Results:
Out of the total 4920 patients registered in the Family Medicine Practice in Sadova (Romania), 25.39% met the inclusion criteria for colorectal cancer screening. Among these eligible patients, 51.28% were women and 48.72% were men. Of the eligible patients, 18.78% enrolled in the screening program and progressed through various stages of the screening process. Out of enrolled patients that underwent a biopsy and received histopathological results, 5.88% were diagnosed with colorectal cancer. Among patients who declined to proceed with colonoscopy, common reasons of refusal included fear, low perceived risk, embarrassment, and a lack of prioritization of their health.
Conclusions:
Despite efforts to increase participation, a significant proportion of eligible patients did not enroll or complete the screening process. By understanding and addressing these factors, healthcare providers and policymakers can enhance the effectiveness and reach of CRC screening programs, ultimately reducing the burden of CRC in rural communities.
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