Factors associated with participation in colorectal cancer screening: a population-based study of 7200 Chinese individuals

Abstract Background Screening for colorectal cancer can reduce mortality, yet, participation rate is suboptimal in various countries. We aimed to evaluate the effectiveness of a pilot programme for colorectal cancer screening on increasing the enabling factors of screening in a large Chinese population, and identified factors associated with its participation based on variables pertinent to the Health Belief Model. Methods We collected data from 3600 screening participants who were randomly selected using a telephone list for 2016, 2017, and 2018, from the government colorectal cancer screening programme. We also collected data from 3600 non-screening participants through a telephone survey via simple random sampling of telephone numbers in a territory-wide directory for the years 2016, 2017, and 2018. We collected sociodemographic factors, the enabling factors of screening (such as knowledge levels of colorectal cancer, perceptions of colorectal cancer screening, cues to actions), and barriers of screening. We constructed a logistic regression model to identify the association between these factors and participation in colorectal cancer screening adjusted for age, gender, educational level, and household income. The study was approved by the Joint Chinese University of Hong Kong − New Territories East Cluster Clinical Research Ethics Committee (reference number 2016.485). Verbal consent was obtained from the study participants. Findings The knowledge level of colorectal cancer screening tools (from 67·9% to 85·4%, p Interpretation These findings demonstrate the effectiveness of the screening programme on increasing the enabling factors and identify the target groups such as younger individuals, females, and more affluent people among whom more intensive educational initiatives are needed to enhance their participation. Funding Health and Medical Research Fund (No. 6904168), Food and Health Bureau, Hong Kong, China.