Barriers and Facilitators of Implementing Colorectal Cancer Screening Management in China: A Mixed-Methods Study.

Abstract

Background: Colorectal cancer is a major cause of cancer-related deaths in China. Timely screening is essential for reducing mortality, but implementing comprehensive programs in Chinese healthcare settings is challenging.

Objective: This study identifies barriers and facilitators to colorectal cancer screening (CRCS) in China and recommends effective implementation strategies.

Methods: Conducted from October 2023 to April 2024, this mixed-methods study under the Consolidated Framework for Implementation Research involved 128 practitioners and 440 residents near 5 community health centers and 4 tertiary care hospitals in Harbin, Heilongjiang Province. Quantitative data were analyzed using descriptive statistics and logistic regression, whereas qualitative data from 21 practitioners and 23 community members underwent directed content analysis.

Results: The study identified 18 facilitators and 29 barriers to CRCS implementation in China, analyzed across 5 Consolidated Framework for Implementation Research domains: innovation (2 facilitators, 5 barriers), outer setting (5 facilitators, 4 barriers), inner setting (3 facilitators, 4 barriers), individual characteristics (5 facilitators, 11 barriers), and implementation process (3 facilitators, 5 barriers).

Conclusion: This study highlights critical facilitators and barriers from the perspectives of healthcare professionals and the screening-eligible population. It suggests strategies to enhance early CRCS initiatives in China, including regular training, public education, financial support, and improved accessibility.

Implications for practice: The findings from this study provide actionable insights for enhancing the implementation of CRCS in Chinese healthcare settings.