Uncovering Barriers and Facilitators in CRC Primary Prevention: Key Findings from the ONCODIR Survey

Between May and August 2024, the ONCODIR consortium spearheaded an insightful online survey aimed at identifying the barriers, facilitators, and vulnerabilities in colorectal cancer (CRC) primary prevention. This survey saw widespread participation, thanks to a comprehensive, closed-ended questionnaire available in multiple languages, Dutch, English, French, German, Greek, Italian, Lithuanian, Romanian, and Spanish. The collaborative effort of consortium partners and promotion via the project’s social media channels resulted in over 4,000 people being reached, with active participation from over 1000 individuals from across Europe.

 

Common Barriers to CRC Prevention

Participants highlighted a range of behavioural and structural barriers to CRC prevention. Notably, structural barriers included financial and economic constraints, geographical disparities, limited accessibility to healthy options & healthcare services, scarcity of support resources, bureaucratic hurdles, and language barriers. On the behavioural front, significant issues such as fear of judgment, stigma, social and cultural influences, lack of knowledge and awareness about healthy choices & support resources, communication challenges, and time constraints were identified.

 

Facilitators to CRC Prevention

The survey also shed light on several facilitators that could enhance CRC prevention efforts. Key among these were improving population health literacy, launching public awareness campaigns about available prevention programs, and fostering partnerships between healthcare providers and community leaders to boost program visibility and accessibility. Creating judgment-free environments, reducing stigmatization, and promoting patient-centred care emerged as crucial facilitators. Additionally, the survey emphasized the importance of providing health information through digital platforms, encouraging the use of mobile apps for health management, developing community outreach and educational programs, and offering resources tailored to the needs of specific populations.

 

In-sample Inequalities

The analysis revealed several significant inequalities among the survey participants. For instance, Lithuanian-speaking respondents felt less informed about preventive health measures compared to other language groups, while Greek-speaking respondents reported financial constraints limiting their access to preventive healthcare. Employment-related factors also influenced negatively their healthcare decisions. Moreover, differences between Southern and Northern respondents were noted regarding the impact of health insurance on healthcare decisions and the perceived accessibility of low-cost or free community health resources.

 

Conclusion

The findings from the ONCODIR survey provide a comprehensive understanding of the barriers and facilitators in CRC primary prevention. By addressing these issues and leveraging identified facilitators, policymakers and healthcare providers can develop more effective prevention strategies. As we move forward, continued collaboration and targeted interventions will be crucial in overcoming these challenges and improving CRC prevention across Europe.

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This project has received funding from the European Health and Digital Executive Agency under grant agreement No 101096667.

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