Colorectal cancer screening using faecal occult blood tests for Indigenous adults: A systematic literature review of barriers, enablers and implemented strategies

Colorectal cancer (CRC) screening using a Faecal Occult Blood Test (FOBT) is a well-established population intervention to reduce mortality and morbidity of CRC. As Indigenous people are not fully benefiting from the screening programs, a greater understanding of barriers and enablers affecting part...

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Bibliographic Details
Published in:	Preventive medicine 2020-05, Vol.134, p.106018-106018, Article 106018
Main Authors:	D'Onise, Katina, Iacobini, Emilia Tiziana, Canuto, Karla Joy
Format:	Article
Language:	eng
Subjects:	Australia Cancer screening Colorectal cancer Colorectal Neoplasms - diagnosis Colorectal Neoplasms - prevention & control Early Detection of Cancer Faecal Occult Blood Test Health Services Accessibility Health Services, Indigenous Humans Indigenous population New Zealand North America Occult Blood Patient Acceptance of Health Care - ethnology Population Groups - ethnology Population Groups - psychology
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Summary:	Colorectal cancer (CRC) screening using a Faecal Occult Blood Test (FOBT) is a well-established population intervention to reduce mortality and morbidity of CRC. As Indigenous people are not fully benefiting from the screening programs, a greater understanding of barriers and enablers affecting participation is needed. Searches were carried out in PubMed, Embase, Sociological Abstracts, Scopus, CINAHL, and selected websites. Both qualitative and quantitative studies related to Indigenous populations of Canada, New Zealand, Australia and the United States of America were assessed for quality and data related to FOBT were extracted and synthetised. A total of 375 publications were identified and screened against the inclusion/exclusion criteria. Thirty-four studies were included in the review. The barriers for participation in CRC screening included the lack of culturally competent health service access, particularly access to Indigenous health service providers. Medical discrimination, long-standing distrust in Western medicine and/or health staff and screening tests were all identified as barriers for Indigenous people. There were a small number of promising interventions to improve participation, which could be considered on a broader scale to increase overall participation by Indigenous people in CRC screening. The review identified barriers and possible enablers for Indigenous participation in the CRC screening program, some which appear to be unique to Indigenous people. Further intervention studies conducted in partnership with Indigenous communities are needed to improve participation. •Indigenous populations have common barriers for CRC screening.•Potential enablers and strategies to improve CRC screening have been identified.•Few CRC screening strategies have been implemented, evaluated and published.
ISSN:	0091-7435 1096-0260