title: Participation rates for organized colorectal cancer screening programmes: an international comparison.
abstract: OBJECTIVE
  Participation, an indicator of screening programme acceptance and effectiveness, varies widely in clinical trials and population-based colorectal cancer (CRC) screening programmes. We aimed to assess whether CRC screening participation rates can be compared across organized guaiac fecal occult blood test (G-FOBT)/fecal immunochemical test (FIT)-based programmes, and what factors influence these rates.
  
  
  METHODS
  Programme representatives from countries participating in the International Cancer Screening Network were surveyed to describe their G-FOBT/FIT-based CRC screening programmes, how screening participation is defined and measured, and to provide participation data for their most recent completed screening round.
  
  
  RESULTS
  Information was obtained from 15 programmes in 12 countries. Programmes varied in size, reach, maturity, target age groups, exclusions, type of test kit, method of providing test kits and use, and frequency of reminders. Coverage by invitation ranged from 30-100%, coverage by the screening programme from 7-67.7%, overall uptake/participation rate from 7-67.7%, and first invitation participation from 7-64.3%. Participation rates generally increased with age and were higher among women than men and for subsequent compared with first invitation participation.
  
  
  CONCLUSIONS
  Comparisons among CRC screening programmes should be made cautiously, given differences in organization, target populations, and interpretation of indicators. More meaningful comparisons are possible if rates are calculated across a uniform age range, by gender, and separately for people invited for the first time vs. previously.
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: Carrie
authors.initials: C
authors.lastname: Klabunde
authors.affiliation: Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden johannes.blom@ki.se.
authors.forename: Johannes
authors.initials: J
authors.lastname: Blom
authors.affiliation: Institute of Social and Preventive Medicine, Division of Chronic Diseases, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bulliard
authors.affiliation: Cancer Prevention and Control Program, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: Garcia
authors.affiliation: Department of Community Medicine and Epidemiology, The Faculty of Medicine, Technion, and Carmel Medical Center Haifa, Israel.
authors.forename: Lea
authors.initials: L
authors.lastname: Hagoel
authors.affiliation: Canadian Partnership Against Cancer, Toronto, Canada.
authors.forename: Verna
authors.initials: V
authors.lastname: Mai
authors.affiliation: NHS Cancer Screening Programmes, Public Health England, Sheffield, UK.
authors.forename: Julietta
authors.initials: J
authors.lastname: Patnick
authors.affiliation: Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Rozjabek
authors.affiliation: Centro di Prevenzione Oncologica Piemonte, AOU Città della Salute e della Scienza, Turin, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Senore
authors.affiliation: Department of Oncology-Pathology, Karolinska Institutet and Regional Cancer Centre Stockholm Gotland, Sweden.
authors.forename: Sven
authors.initials: S
authors.lastname: Törnberg
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003625:Data Collection; D055088:Early Detection of Cancer / Q000379:methods*; D005243:Feces; D005260:Female; D006138:Guaiac; D006801:Humans; D007391:International Cooperation; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D018579:Patient Selection; D012737:Sex Factors; D011795:Surveys and Questionnaires
chemical_list: D006138:Guaiac
keywords: Colorectal; FOBT; neoplasm; organized programmes; participation; population; screening; uptake