Hamer-Kiwacz Sienna, Berntsson Hannah, Galloway George, Tran Ann-Marie, Tan Jia Yun, Hind Daniel, Kurien Matthew
Division of Population Health, School of Medicine and Population Health, The University of Sheffield, Sheffield, UK.
The Medical School, The University of Sheffield, Sheffield, UK.
J Eval Clin Pract. 2025 Mar;31(2):e14120. doi: 10.1111/jep.14120. Epub 2024 Sep 18.
Faecal immunochemical testing (FIT) is used to triage people with signs or symptoms of a colorectal cancer (CRC). Recent guidelines have recommended further research to improve access, uptake and return of FIT. This systematic scoping review aims to understand the barriers and facilitators to FIT testing in symptomatic patients.
Qualitative, quantitative and mixed-methods studies published after September 2013 were included. MEDLINE, EMBASE and PsycINFO databases were searched to identify publications examining barriers and facilitators to FIT. Initially, the data underwent thematic analysis, and subsequently, factors were aligned to components of the Capability, Opportunity, Motivation, Behaviour model. All outcomes are presented in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
One thousand two hundred thirty-two papers were identified; 11 met the inclusion criteria. Barriers and facilitators were identified at the patient (e.g., knowledge), provider (e.g., general practitioner awareness) and service level (e.g., method of providing FIT kits). Factors were categorised into the subcomponents of the model: psychological capability (e.g., lack of FIT knowledge), reflective motivation (e.g., beliefs regarding FIT sampling and faeces being unhygienic) and automatic motivation (e.g., embarrassment, scary, anxiety provoking). Gaps in knowledge emerged in three domains: (1) patient experience, (2) FIT pathway and (3) healthcare professionals experience of FIT.
This systematic scoping review provides a summary of the literature on FIT uptake, and identified factors across multiple levels and components. To increase adherence to FIT completion within primary care, a multifaceted theory and evidence-based approach is needed to underpin future behavioural science interventions.
粪便免疫化学检测（FIT）用于对有结直肠癌（CRC）体征或症状的人群进行分流。近期指南建议开展进一步研究，以改善FIT检测的可及性、接受度和检测结果反馈情况。本系统综述旨在了解有症状患者进行FIT检测的障碍和促进因素。
纳入2013年9月之后发表的定性、定量及混合方法研究。检索MEDLINE、EMBASE和PsycINFO数据库，以识别研究FIT检测障碍和促进因素的出版物。首先，对数据进行主题分析，随后将因素与“能力、机会、动机、行为”模型的各个组成部分进行匹配。所有结果均按照系统评价和Meta分析的首选报告项目指南呈现。
共识别出1232篇论文；11篇符合纳入标准。在患者层面（如知识水平）、医疗服务提供者层面（如全科医生认知度）和服务层面（如提供FIT检测试剂盒的方式）均识别出了障碍和促进因素。这些因素被归类到模型的子成分中：心理能力（如缺乏FIT知识）、反思性动机（如对FIT样本采集以及粪便不卫生的看法）和自动性动机（如尴尬、可怕、引发焦虑）。在三个领域出现了知识缺口：（1）患者体验，（2）FIT检测流程，（3）医疗保健专业人员对FIT检测的体验。
本系统综述总结了关于FIT检测接受情况的文献，并识别出了多个层面和组成部分的因素。为提高初级保健中FIT检测的完成率，需要一种多方面的基于理论和证据的方法来支持未来的行为科学干预措施。
