Král N, Seifert B, Suchánek Š, Zavoral M, Májek O
Epidemiol Mikrobiol Imunol. 2015 Mar;64(1):41-6.
The mortality of colorectal cancer (CRC) is significant worldwide. There is good evidence for benefits of the CRC screening in mortality reduction. Since 2009, the population of the Czech Republic have had two CRC screening options from which to choose: a faecal occult blood test (FOBT) at the age of 50 to be repeated every two years or primary screening colonoscopy (PSC) at the age of 55. General practitioners play a crucial role in the CRC screening programme. The CRC screening adherence of the Czech population is poor and does not exceed 25%.
The aims of the study were to analyse the reasons behind the low CRC screening adherence of the Czech population, to classify the populations attitudes, and to identify the barriers. A questionnaire survey was conducted in a Czech energy company with 13,000 employees in 2011-2012. The questionnaire was administered electronically by e-mail or directly at the workplace.
The questionnaire response rate was 31.3% (4070). The pool of respondents consisted of 2804 (68.9%) females and 1266 (31.1%) males. Of the respondents, 1345 (33.1%) were aged over 50 years (73.5% women and 26.5% men). Of the cohort aged over 50, 68.65% of women and 63.2% of men took a FOBT. Ten percent of respondents aged over 50 years have never heard of CRC screening and 32.8% of this age category have never participated in CRC screening. The main reasons for not taking a FOBT were feeling well and having no health problems (38.8%) or FOBT not offered the by the general practitioner (27.8%). Other reasons were no time to do so, fear of the result, unsure of the procedure, unawareness of what FOBT is, or uncomfortable about the test procedure. On the other hand, 8.37% of the participants aged between 15 and 39 years and 20.7% of those aged between 40 and 49 years have already taken a FOBT. Overall, 15.4% of respondents prefer the new alternative, PSC, as the CRC screening option. Significant differences in CRC screening adherence are seen between administrative regions of the Czech Republic and between education levels.
From the results, it follows that a considerable proportion of the population of the Czech Republic do not understand the principle of CRC screening and its methods. Enough room has been left to promote education on CRC screening for both the public and general practitioners. On the other hand, a large part of proactive individuals participate in CRC screening before the age of 50.
结直肠癌（CRC）在全球范围内死亡率颇高。有充分证据表明CRC筛查对降低死亡率有益。自2009年起，捷克共和国民众有两种CRC筛查方案可供选择：50岁时进行粪便潜血试验（FOBT），每两年重复一次；或55岁时进行初次筛查结肠镜检查（PSC）。全科医生在CRC筛查项目中起着关键作用。捷克民众对CRC筛查的依从性较差，不超过25%。
本研究旨在分析捷克民众CRC筛查依从性低的原因，对民众态度进行分类，并找出障碍。2011 - 2012年在一家拥有13000名员工的捷克能源公司进行了问卷调查。问卷通过电子邮件或在工作场所直接以电子方式发放。
问卷回复率为31.3%（4070份）。受访者群体包括2804名（68.9%）女性和1266名（31.1%）男性。在受访者中，1345名（33.1%）年龄超过50岁（女性占73.5%，男性占26.5%）。在50岁以上的人群中，68.65%的女性和63.2%的男性进行了FOBT。50岁以上的受访者中有10%从未听说过CRC筛查，该年龄组中有32.8%从未参加过CRC筛查。不进行FOBT的主要原因是感觉良好且没有健康问题（38.8%）或全科医生未提供FOBT（27.8%）。其他原因包括没有时间做、害怕结果、对检查程序不确定、不知道FOBT是什么或对检查程序感到不适。另一方面，15至39岁的参与者中有8.37%，40至49岁的参与者中有20.7%已经进行了FOBT。总体而言，15.4%的受访者更喜欢新的选择PSC作为CRC筛查方案。捷克共和国不同行政区和不同教育水平之间在CRC筛查依从性方面存在显著差异。
从结果来看，相当一部分捷克民众不理解CRC筛查的原理及其方法。在对公众和全科医生进行CRC筛查教育方面仍有很大空间。另一方面，很大一部分积极主动的人在50岁之前就参与了CRC筛查。
