沙特成年人群结直肠癌筛查的障碍：一项系统回顾和荟萃分析

IF 1.9 Q2 MEDICINE, GENERAL & INTERNAL

Journal of Taibah University Medical Sciences Pub Date : 2025-09-22 DOI:10.1016/j.jtumed.2025.09.001

Mohammed Aldakhil MD , Raghad Ibrahim albarrak MD , Rose khalaf Alharbi MD , Yara Fahad Almazyad MD , Rawan Khaled Alharbi MD , Lama Abdullateef Albshry MD , Layan Abdulaziz Altuwejri MD , Dalia Abdulrhman Alammari MD , Ghadah Abdulrahman Alsuhaibani MD

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引用次数: 0

摘要

结直肠癌（CRC）是沙特阿拉伯第二大流行癌症，也是胃肠道癌症相关死亡的主要原因。尽管有有效的筛查方法，但参与率仍然很低，导致诊断延迟和预后不良。障碍包括有限的认识、文化信仰、卫生保健系统限制和医生建议不足。现有的研究显示出不同的结果，突出了全面综合的必要性。目的通过检查个人、医疗体系和社会文化因素，确定并分类沙特阿拉伯结直肠癌筛查的障碍，并为提高筛查率提供建议。方法系统检索PubMed、Embase、谷歌Scholar、Saudi Digital Library和Cochrane Library。符合条件的研究使用定量或定性方法检查了沙特成年人进行结直肠癌筛查的障碍。排除了非沙特、非人类、回顾性研究或方法学不明确的研究。两名独立审稿人使用ROBINS-I对观察性研究和Cochrane随机对照试验的偏倚风险工具进行数据提取和质量评估。异质性评价采用Cochran’s Q和I²，发表偏倚评价采用Begg’s检验。结果在筛选的130项研究中，14项符合纳入标准。最常见的障碍是缺乏知识、缺乏医生推荐、文化污名、与性别有关的担忧和获取途径有限。meta分析显示高异质性（I²= 83.9%,p < 0.001）。医生建议是参与的最强预测因子，而污名和获取问题是关键的阻碍因素。未发现发表偏倚（Begg检验p = 0.296）。结论沙特阿拉伯的crc筛查受到多因素障碍的阻碍。有针对性的认识、医生驱动的举措、改善可及性和文化敏感的干预措施对于提高参与和降低结直肠癌死亡率至关重要。

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Barriers to colorectal cancer screening tests among adults in the Saudi population: A systematic review and meta-analysis

Introduction

Colorectal cancer (CRC) is the second most prevalent cancer in Saudi Arabia and the leading cause of gastrointestinal cancer-related mortality. Despite effective screening methods, participation remains low, resulting in delayed diagnoses and poor outcomes. Barriers include limited awareness, cultural beliefs, healthcare system constraints, and insufficient physician recommendations. Existing studies show variable findings, highlighting the need for a comprehensive synthesis.

Objective

To identify and categorize barriers to CRC screening in Saudi Arabia by examining individual, healthcare system, and sociocultural factors, and to provide recommendations for improving screening uptake.

Methods

A systematic search of PubMed, Embase, Google Scholar, the Saudi Digital Library, and the Cochrane Library was performed. Eligible studies examined barriers to CRC screening among Saudi adults using quantitative or qualitative methods. Non-Saudi, non-human, review, or methodologically unclear studies were excluded. Two independent reviewers conducted data extraction and quality assessment using ROBINS-I for observational studies and the Cochrane Risk of Bias Tool for RCTs. Heterogeneity was evaluated with Cochran’s Q and I², while publication bias was assessed using Begg’s test.

Results

Of 130 studies screened, 14 met the inclusion criteria. The most frequent barriers were lack of knowledge, absent physician recommendation, cultural stigma, gender-related concerns, and limited access. Meta-analysis revealed high heterogeneity (I² = 83.9%, p < 0.001). Physician recommendation was the strongest predictor of participation, while stigma and access issues were key deterrents. No publication bias was detected (Begg’s test p = 0.296).

Conclusion

CRC screening in Saudi Arabia is hindered by multifactorial barriers. Targeted awareness, physician-driven initiatives, improved access, and culturally sensitive interventions are essential to enhance participation and reduce CRC mortality.

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