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Objective: To evaluate the quality of colonoscopies performed after a positive faecal immunochemical test in the French colorectal cancer screening programme. Methods: Retrospective analysis of all colonoscopies performed between 2015 and 2019 after a positive quantitative faecal immunochemical test in the population-based colorectal cancer screening programme organised in Alsace, part of the French programme. The following indicators were evaluated: annual colonoscopy volume, caecal intubation rate, adenoma detection rate, proximal serrated lesion detection rate and proportion of patients referred directly to surgery for benign polyp management. Endoscopists who performed <30 faecal immunochemical test positive colonoscopies were non-assessable. Results: Overall, 13,455 faecal immunochemical test-positive colonoscopies performed by 116 community gastroenterologists were included, 13,067 of them by 80 assessable endoscopists. The overall caecal intubation, adenoma detection and proximal serrated lesion detection rates were 97.9%, 57.6% and 7.6%, respectively. They were <90%, <45% and <1% for 1.3%, 12.5% and 6.3% of the endoscopists, respectively. Overall, 1028 (7.9%) individuals were examined by 13 low-performing endoscopists and 328 (2.4%) individuals by 33 low-volume non-assessable endoscopists. Among 9133 individuals harbouring polyps, 155 (1.7%) had unwarranted surgery for a benign polyp. Overall, 1487 individuals (11.1%; 95% confidence interval 10.5–11.6) were not given the best possible chances, whereas 5545 individuals (41.2%; 95% confidence interval 40.4–42.0) were offered the best possible chances by 37 endoscopists. Conclusions: At programme level, the key performance indicators evaluated largely exceeded the target standards. At individual level, at least one in nine individuals was not given the best possible chances during faecal immunochemical test-positive colonoscopies by a minority of poor-performing and/or low-volume endoscopists. [ABSTRACT FROM AUTHOR]

Background: Most of the individuals concerned by colorectal cancer screening recognize the importance of screening participation. However, the screening rates for this cancer remain low in most countries, including France. Based on the action control framework, the present study aimed to (i) explore the distribution of intentions-behavior profiles toward colorectal cancer screening and (ii) to determine to what extent the profiles could be differentiated on theory of planned behavior (TPB) (i.e., attitudes, subjective norms, perceived behavioral control [PBC]) and self-regulation variables (i.e., action planning, coping planning). Method: A total of 149 participants from the general French population (M = 60 years, SD = 7.04) completed a questionnaire measuring TPB and self-regulation variables. Subsequent screening behavior was determined from medical records. Participants were notably categorized as non-intenders, unsuccessful intenders, or successful intenders. Data were analyzed using discriminant function analysis and analyses of covariance. Results: Main findings revealed that 71% of the intenders were unsuccessful intenders. TPB and self-regulation variables were significantly correlated with the discriminant function (rs ≥.40). Successful and unsuccessful intenders reported significantly higher levels of subjective norms, PBC, and coping planning than non-intenders (ps <.01). Successful intenders reported a significantly higher level of coping planning than unsuccessful intenders (p <.01). Conclusions: Further research appears necessary to empirically test to what extent interventions targeting subjective norms, PBC, and coping planning could enhance the proportion of successful intenders toward colorectal cancer screening. [ABSTRACT FROM AUTHOR]

Based on the theory of social representations, this study aims to identify the main determinants to participation in colorectal cancer screening. Six focus groups (N = 29 participants belonging to the general population) were conducted, followed by a theoretical thematic analysis. Screening obstacles are a lack of test's accessibility, a low preoccupation for prevention and the negative image of colorectal cancer. Conversely, screening facilitators are the ease of the new test, being encouraged to get screened and appointment reminder. This study advances understanding of adherence to screening by addressing the beliefs and knowledge surrounding it. [ABSTRACT FROM AUTHOR]