Objective To investigate the influencing factors of compliance to colonoscopy among colorectal cancer (CRC) high-risk populations in Jing'an District of Shanghai, and to provide evidence for early-stage colorectal screening and prevention in this area.
Methods In 2013, 2 061 volunteers at high risk of CRC in Jing'an District were selected by simple random sampling and interviewed using structured questionnaire to analyze their compliance to colonoscopy and related influencing factors.
Results There were totally 1 817 valid questionnaires with a valid rate of 88.16%, and 578 volunteers received colonoscopy with a compliance rate of 31.81%. According to logistic regression analysis, "no symptoms and regarding colonoscopy as meaningless" (OR=10.95), "no disease diagnosed in routine health checks" (OR=1.93), "no time" (OR=2.63), "symptoms occurred already" (OR=2.23), and "classification of positive results" (OR=2.04/3.95) were unfavorable factors; by contrast, "awareness of types and frequencies of colon examinations" (OR=0.46), "complex colorectal preparation before colonoscopy" (OR=0.15), "easy access in hospitals" (OR=0.55), "advices from community physicians" (OR=0.52), "advices from physicians of secondary and tertiary hospitals" (OR=0.50), "being willing of taking screening if free of charge" (OR=0.54) were favorable factors.
Conclusion No correlation has been found between social-demographic factors and colonoscopy compliance. There are several methods to improve colonoscopy compliance among the high-risk population of colorectal cancer. The government should strengthen health promotion on colonoscopy knowledge, increase the proportion of fee exemption, extend easy access in hospitals, enhance training on physicians, provide more standardized physical check-ups, classify high-risk populations according to different risk level, and conduct varied screening strategies.
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