Comparison of uptake of colorectal cancer screening based on fecal immunochemical testing (FIT) in males and females: a systematic review and meta-analysis.
BACKGROUND
Colorectal cancer is the third most common cancer in males and the second in females worldwide. Incidence and mortality are higher in men than women. Colorectal cancer screening is effective in reducing mortality. Internationally, fecal immunochemical testing (FIT) is increasingly being recommended as the primary screening test. This systematic review and meta-analysis aimed to determine whether uptake of FIT screening differs between men than women.


METHODS
We searched PubMed and Embase for peer-reviewed articles published in English during 2000-2013 for randomized controlled trials (RCT) or observational studies of screening using FIT that quantified numbers invited and participating by gender. Meta-analysis was performed using a random effects model.


RESULTS
Six hundred and eighty-five citations were identified, 19 meeting the inclusion criteria. Random effects meta-analysis found male uptake was significantly lower than female uptake [odds ratio (OR), 0.84; 95% confidence interval (CI), 0.75-0.95; P < 0.01]. This generally persisted throughout subgroup analysis of study design (RCTs vs. observational studies and study quality), screening organization (methods of invitation, number of samples, age range of screening, recommendations, and reminders), and setting.


CONCLUSIONS
Meta analysis of FIT screening studies indicates significantly lower uptake among men.


CONCLUSIONS
Further investigation is required into factors influencing acceptability and participation of FIT screening in both sexes.
National Cancer Registry Ireland, Cork, Ireland. Department of Epidemiology and Public Health, University College Cork, Cork, Ireland. n.clarke@ncri.ie.
Nicholas
N
Clarke
National Cancer Registry Ireland, Cork, Ireland.
Linda
L
Sharp
Centre for Mens Health, Institute of Technology Carlow, Carlow, Ireland.
Aoife
A
Osborne
Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
Patricia M
PM
Kearney
D015179:Colorectal Neoplasms / Q000175:diagnosis; D055088:Early Detection of Cancer; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male