Discrepancies and misconceptions of perceived colorectal cancer screening barriers between primary health professionals and unscreened population. A comparative study in Greece.

PURPOSE: Our study aimed to compare the views of healthy eligible unscreened adults, to those of primary care providers in Greece, about colorectal cancer (CRC) screening perceived barriers.

METHODS: A sample of 791 unscreened adults (50-75 years) from a recent nationwide health survey in Greece were interviewed about CRC screening barriers, and the main reason for not adhering to colonoscopy and fecal occult blood test (FOBT) was assessed. Results were compared to a concurrent survey of 161 primary care professionals (PCPs) from the same region and the agreement with the general population was assessed with odds ratios (OR) and 95% confidence intervals (CI).

RESULTS: General population stated as a primary barrier for colonoscopy, at a significant higher frequency than the PCPs (p<0.001), lack of symptoms (44.5 vs 5.7%), negligence (14.2 vs 3.8%) and lack of PCP recommendation (9.2 vs 2.5%). PCPs were more likely to agree for fear of pain of colonoscopy (OR:19.6, 95%CI 9.3-41.4), fear of cancer diagnosis (OR:17.7, 95%CI 10.8-29.1), and embarrassment (OR:13.8, 95%CI 8.1-23.6). Regarding FOBT, the most frequent barrier for the unscreened population compared to PCPs (p<0.001), was lack of symptoms (38.2 vs 3.9%), followed by unawareness of the test (22.9 vs 55.2%) and lack of PCP recommendation (13% vs 12.3%). The only barrier that PCPs agreed at significantly lower frequency was the lack of physician recommendation (OR:0.3; 95%CI 0.2-0.4).

CONCLUSIONS: PCPs do not share the same views as the general population about CRC screening barriers in Greece. PCPs should focus counseling on patient perceived barriers in order to promote adherence.