Could a Behavioral Model Explain Adherence to Second-Level Colonoscopy for Colon Cancer Screening? Results of a Cross-Sectional Study of the Palermo Province Population

Giuseppa Minutolo, Palmira Immordino, Alessia Dolce, Mario Valenza, Emanuele Amodio, Walter Mazzucco, Alessandra Casuccio and Vincenzo Restivo
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Giuseppa Minutolo: Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
Palmira Immordino: Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
Alessia Dolce: Local Health Unit of Palermo, 90100 Palermo, Italy
Mario Valenza: Local Health Unit of Palermo, 90100 Palermo, Italy
Emanuele Amodio: Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
Walter Mazzucco: Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
Alessandra Casuccio: Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
Vincenzo Restivo: Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy

IJERPH, 2022, vol. 19, issue 5, 1-12

Abstract: According to Italian Essential Levels of Assistance (ELA), a colonoscopy is strongly recommended after a positive fecal occult blood test (FOBT) due to its effectiveness in early colorectal cancer detection. Despite the evidence, the Palermo province population (Italy), after a positive FOBT, have a lower colonoscopy adherence compared to Italian standards. This cross-sectional study analyzed patients’ perceptions of colonoscopy procedures to understand the reasons for non-adherence. Patients with a positive FOBT who did not undergo a colonoscopy within the national organized screening program were administered a telephone interview based on the Health Belief Model (HBM) questionnaire. The number of non-compliant patients with a colonoscopy after a positive FOBT were 182, of which 45 (25.7%) patients had undergone a colonoscopy in another healthcare setting. Among the HBM items, in a multivariate analysis only perceived benefits were significantly associated with colonoscopy adherence (aOR = 6.7, p = 0.03). Health promotion interventions should focus on the importance of the benefits of colorectal screening adherence to prevent colorectal cancer, implementing health communication by healthcare workers that have closer contacts with people, as general practitioners.

Keywords: colorectal cancer; screening; colonoscopy; adherence; health belief model; perceived benefit (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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