Determinants of participation in colorectal cancer screening with faecal occult blood testing

Colorectal cancer is one of the most common cancers in men and women. Participation rates in faecal occult blood testing (FOBT) screening activities are, however, relatively low. In terms of lowering the colorectal cancer mortality, high participation rates are essential, and therefore it is important to understand the barriers to FOBT screening. We undertook a systematic search through PUBMED, Medline, EMBASE and PsycINFO in order to identify studies that provide information on socio-demographic determinants of participation in FOBT screening. FOBT participation varied considerably across countries, but they have rarely been above 60%. The use of other health-care services was in most studies a strong determinant for participation in screening with FOBT. There was a tendency to higher participation among women than among men and among married as opposed to not married, but determinants varied across countries and test settings. There was no systematic variation in participation across age groups. The participation pattern depends in part on local circumstances, which makes it difficult to point to a general strategy for increasing the uptake in FOBT screening. This stresses the need for monitoring of individual screening programmes and developing information strategies targeted to the local participation pattern.