A ‘one stop cancer screening shop’, a way of improving screening participation rates?

Abstract

Background: It is well established that cancer screening programs can reduce morbidity and mortality, however, research demonstrates that screening programs are underutilised by the target populations. Therefore the aim of this study was to investigate enablers and barriers to cancer screening and how screening participation may be improved. Method(s): Participants who were randomly selected from northern and western suburbs of Adelaide, Australia answered online or paper based questionnaires about health issues and service utilization. Data were collected from 10th August-20th December 2015, weighted for selection probability, age and sex and analysed using SPSSv20. Result(s): 2,895 questionnaires were sent, with 1,562 returned (54.1%). Respondents included 754 males and 808 females with a mean age of 54.1yrs (+ 15.2). Current cancer screening participation included cervical 34.4% (CI 32.1-36.8), bowel 34.1% (CI 31.7-36.4), breast 28.7% (CI 26.5-31.0) and prostate, 17.4% (CI 15.6-19.4). Commonly cited reasons for screening participation included; preventing sickness (CI 56.1%, 53.2-59.0), maintaining health (CI 51%, 48-53.9), free program (CI 30.9%, 38.2-33.6) and family history of cancer (20.9% (CI 18.7-23.4). The most common screening barrier was irrelevance of screening to the person (CI 20.8%, 17.2-24.8), with a small proportion stating time (CI 6.9%, 4.9-9.7) and cost restraints (CI 5.2%, 3.5-7.7). Ninety three percent (CI 91.7-94.2) of respondents thought cancer screening was beneficial, with the majority (85.3%, CI 83.4-86.9) supporting the concept of different types of screening being provided at the one site. Conclusion(s): Participation rates in individually offered cancer screening programs (colorectal, breast, cervical) remain low. The enablers and barriers to screening participation cited in this study are in concert with those in the published literature, however, an overwhelming percentage of respondents would support a combined cancer screening service. Offering a combined, co-located service - a 'one stop cancer screening shop' has the potential to address barriers to screening (such as time constraints), improve participation rates and maximize utilization of public health resources.