DISCREPANCIES BETWEEN PREFERRED AND ACTUAL UTILIZATION OF COLORECTAL CANCER SCREENING: A COMPREHENSIVE REVIEW OF DEMOGRAPHIC AND MULTIFACTORIAL DETERMINANTS
DOI:
https://doi.org/10.31435/ijitss.2(50).2026.5651Keywords:
Colorectal Cancer Screening, Diagnostic Adherence, Intention-Behavior Gap, Non-Invasive Diagnostics, Patient Preference, Socio-Demographic DeterminantsAbstract
Objectives: Preferences for colorectal cancer (CRC) screening methods vary significantly across socio-economic and demographic groups. This review describes and quantifies the notable discrepancy between patients' declared choices and actual participation in early detection strategies. It also identifies the underlying determinants driving this persistent intention-behavior gap.
Methods: A narrative synthesis of the literature (2012–2026) was conducted using the PubMed database. The analysis focused primarily on peer-reviewed studies, supplemented by a relevant preprint. This research examines patient inclinations regarding various CRC screening methods, real-world adherence rates, and the socio-demographic determinants shaping the actualization of preventive choices and long-term compliance.
Key Findings: While clinicians almost unanimously favor colonoscopy, the vast majority of patients prefer non-invasive alternatives. This discrepancy is driven primarily by test characteristics—such as bowel preparation requirements, testing frequency, and perceived capability to complete the diagnostic pathway—as well as logistical constraints, including disruption of daily routines and the time required. Regardless of declared preferences, the actual proportion of individuals undergoing clinical evaluation remains insufficient. Age, race and ethnicity, comorbid gastrointestinal diseases, a family history of CRC, and educational attainment act as primary demographic determinants dictating these modality selections. Healthcare system architecture also proves decisive. Specifically, active and patient-navigated frameworks exhibit greater participation than passive models.
Conclusion: Closing the CRC screening intention-behavior gap requires transitioning toward genuine shared decision-making. Improving compliance heavily relies on integrating highly tolerable diagnostic methods with supportive healthcare infrastructures, structured patient navigation, and an empathetic approach to clinical care.
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Copyright (c) 2026 Martyna Lipiarz, Michał Niespodziewański, Patrycja Szczygielska, Sylwia Hejna, Weronika Smutkiewicz, Weronika Teterycz, Wiktoria Goździejewska, Łukasz Jaworek, Gabriela Zimka, Krystian Bjorgen
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