title: Prospective cohort study of compliance with faecal immunochemical tests for colorectal cancer screening in Hong Kong.
abstract: OBJECTIVE
  This study aims to examine the rate and determinants of faecal immunochemical test (FIT) compliance over a four-year period among asymptomatic participants in a colorectal cancer (CRC) screening programme in Hong Kong.
  
  
  METHODS
  Self-referred screening participants aged between 50 and 70 years who chose FIT for annual screening were followed up for four years (2008-2012). All participants were reminded up to three times yearly for FIT retrieval within two months of the expected screening date. The proportions of screening participants who failed to adhere to annual FIT tests in 1, 2, 3 and 4-years, respectively, after the initial screening uptake were evaluated. The factors associated with non-compliance with FITs in any year were assessed by a binary logistic regression analysis.
  
  
  RESULTS
  From 5700 consecutive screening participants, the compliance rates to FIT were 95.1%, 79.9%, 66.2% and 68.4% at years one to four, respectively. The proportions of people missing one, two and three tests were 6.2%, 19.6% and 2.1%, respectively. From multivariate regression analysis, male subjects, younger participants, smokers and those with positive family history of CRC were more likely to be non-compliant.
  
  
  CONCLUSIONS
  Participants identified as at higher risk for screening non-compliance should be especially considered for individual reminders to enhance screening effectiveness.
authors.affiliation: Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, 7/F, Prince of Wales Hospital, Shatin, NT, Hong Kong. wong_martin@cuhk.edu.hk
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.forename: Jessica Y L
authors.initials: JY
authors.lastname: Ching
authors.forename: Thomas Y T
authors.initials: TY
authors.lastname: Lam
authors.forename: Arthur K C
authors.initials: AK
authors.lastname: Luk
authors.forename: Hoyee W
authors.initials: HW
authors.lastname: Hirai
authors.forename: Sian M
authors.initials: SM
authors.lastname: Griffiths
authors.forename: Francis K L
authors.initials: FK
authors.lastname: Chan
authors.forename: Joseph J Y
authors.initials: JJ
authors.lastname: Sung
mesh_terms: D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D006723:Hong Kong; D006801:Humans; D007159:Immunologic Tests; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance; D011446:Prospective Studies; D012959:Socioeconomic Factors
keywords: AOR; Adjusted Odds Ratios; CRC; Colorectal Cancer; Colorectal cancer; Compliance; Determinants; FIT; FOBT; Faecal Immunochemical Tests; Faecal Occult Blood Tests; Faecal occult blood; Screening