Colorectal cancer screening attendance influencing factors and coverage improvement options in general practice

Colorectal cancer is the third most common oncology in Latvia. Finding colorectal cancer in early stages provides the greatest chance for complete recovery. The aim of this study was to find out whether patient attendance improves when patients are personally invited to do the test and whether there is a difference between made tests in rural and urban general practitioner (GP) practices. The study was conducted in two GP practices in Latvia – one in Madona city, and second - rural area of Gulbene. A study was designed during 2020. We compared data before and after engaging a resident in GP practices: in rural practice since 26.08.2020., in urban practice - 19.10.2020. Analysis of screening attendance was made, based on data from given and executed immunochemical fecal occult blood tests (I-FOBT). We compared factors (age, sex and location) influencing I-FOBT performance. Microsoft Excel 2012 and IBM SPSS were used for statistical analysis. 633 patients aged 50-74 were the target population for colorectal cancer screening in both GP practices. 137 patients (21,64%) took the I-FOBT (mean age 60,31± 6,55; 56,20% women and 43,80% men), but only 87 (63,50%) patients (mean age 61,10 ± 6,88; 54,02% women and 45,98% men) did it (p>0,05). There is a statistically significant difference (p<0,05) between made tests in the rural practice (31 tests or 52,54% of all the given tests) and in the urban practice (56 tests or 71,79% of all). Testing was improved by 49,16% in rural practice and by 30,76% in urban practice after engaging a GP resident. The performance of the test was influenced by the location of the GP practice, but there was no difference between the patients’ sex or age. Colorectal cancer screening attendance can be greatly improved with the help of GP residents and a more personalized approach.