title: Colorectal cancer screening participation: a systematic review.
abstract: BACKGROUND
  Colorectal cancer (CRC) is one of the most common cancers in men and women. CRC screening programmes have been implemented in various countries. However, the participation rate remains disappointingly low. For a screening method to be beneficial, high participation rates are essential. Therefore, understanding the factors that are associated with CRC screening and follow-up adherence is necessary. In this systematic review, factors studied in literature were identified that are associated with CRC screening adherence.
  
  
  METHODS
  A systematic search in PUBMED, EMBASE and COCHRANE was performed to identify barriers and facilitators for CRC screening adherence. Study characteristics were summarized and analysed.
  
  
  RESULTS
  Seventy-seven papers met the inclusion criteria to be applicable for review. Female gender, younger participants, low level of education, lower income, ethnic minorities and not having a spouse were the most frequently reported barriers. Health provider characteristics, such as health insurance and a usual source of care were also frequently reported barriers in CRC screening adherence. Disparities were found in weight, employment status and self-perceived health status.
  
  
  CONCLUSIONS
  Barriers and facilitators of CRC screening participation are frequently reported. Understanding these factors is the first step to possibly modify specific factors to increase CRC screening participation rate.
authors.affiliation: 1 Faculty of Medicine, University of Utrecht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Wools
authors.affiliation: 1 Faculty of Medicine, University of Utrecht, The Netherlands.
authors.forename: E A
authors.initials: EA
authors.lastname: Dapper
authors.affiliation: 2 Julius Center, Division of Public Health, University of Utrecht, The Netherlands j.r.j.deleeuw@umcutrecht.nl.
authors.forename: J R J
authors.initials: JR
authors.lastname: de Leeuw
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data*; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012737:Sex Factors; D012959:Socioeconomic Factors