title: Systematic Review and Meta-study Synthesis of Qualitative Studies Evaluating Facilitators and Barriers to Participation in Colorectal Cancer Screening.
abstract: Screening reduces the incidence, morbidity, and mortality of colorectal cancer, yet participation tends to be low. We undertook a systematic review and meta-study synthesis of qualitative studies to identify facilitators and barriers to colorectal cancer screening participation. We searched major bibliographic databases for records published in all languages from inception to February 2015. Included primary studies that elicited views and perceptions towards colorectal cancer screening were appraised for relevance and quality. We used a two-stage synthesis to create an interpretation of colorectal cancer screening decisions grounded in primary studies; a thematic analysis to group themes and systematically compare studies and a meta-synthesis to generate an expanded theory of colorectal cancer screening participation. Ninety-four studies were included. The decision to participate in colorectal cancer screening depended on an individual's awareness of colorectal cancer screening. Awareness affected views of cancer, attitudes towards colorectal cancer screening modalities, and motivation for screening. Factors mediating awareness included public education to address misconceptions, primary care physician efforts to recommend screening, and the influence of friends and family. Specific barriers to participation in populations with lower participation rates included language barriers, logistical challenges to attending screening tests, and cultural beliefs. This study identifies key barriers, facilitators, and mediators to colorectal cancer screening participation. Cancer Epidemiol Biomarkers Prev; 25(6); 907-17. ©2016 AACR.
authors.affiliation: Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
authors.forename: Gladys N
authors.initials: GN
authors.lastname: Honein-AbouHaidar
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Monika
authors.initials: M
authors.lastname: Kastner
authors.affiliation: Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
authors.forename: Vincent
authors.initials: V
authors.lastname: Vuong
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
authors.forename: Laure
authors.initials: L
authors.lastname: Perrier
authors.affiliation: Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
authors.forename: Corinne
authors.initials: C
authors.lastname: Daly
authors.affiliation: Cancer Care Ontario, Toronto, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Rabeneck
authors.affiliation: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
authors.forename: Sharon
authors.initials: S
authors.lastname: Straus
authors.affiliation: Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada. baxtern@smh.ca.
authors.forename: Nancy N
authors.initials: NN
authors.lastname: Baxter
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003144:Communication Barriers; D003657:Decision Making; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009042:Motivation; D010361:Patients / Q000523:psychology*