APH 2001, 59, 167-180:

Management of a prostate cancer screening research program in the city of Antwerp.

B. Standaert, A. Alwan, B. Dourcy-Belle-Rose, V. Nelen and L. Denis

Keywords: infant mortality, Brazil, family health program

Objective: To investigate the value of the management of a prostate cancer-screening research program in the city of Antwerp through the evaluation on non-participation.

Methods: The cancer screening study targeted men aged 55 to 74 years living in two districts (Deurne and Borgerhout) of Antwerp city.  The districts are subdivided in 37 sectors with a total of 11,382 subjects to be contacted.  Retrospective analysis of non-participation per sector was studied regarding sector specific variables and the reasons of non-participation.  It was hypothesized that sector specific characteristics may influence the rate of non-participation.  Moreover it was searched if some of these variables could be correlated with individual reasons of non-participation.  Sector specific variables were: the average distance to the research center; the invitation period; the age-composition; the social class; the population density; the general practitioner (GP) density; and the district area (Borgerhout or Deurne).  The individual reasons asked among the home visited non-participants were: "No Interest" in the program; "Consult aGP"; "Being Absent" during the invitation period; and "Other Reasons".

Correlation statistics, non-parametric tests, and regression analysis are used to determine variables that may explain the variation in the rate of non-participation per sector.

Results: Average non-participation rate per sector was 70% (range 61% to 79%).  Non-participation was highly correlated with "Invitation Period" and "Age-Specific" groups.  Individual responses were highly correlated with these variables and inter-correlated between "Being Absent", "Consult a GP" and having "No Interest" and "Other Reasons".  Multiple regression analysis suggests that the rate of non-partcipation per sector increases  significantly with "Being Absent", and a dominant presence in a sector of 55-59 years old subjects.  The fitted model explained around 60% of the variation.

Conclusion: Rates of participation to the prostate cancer research screening of men aged 55 to 74 years old could be improved if the project management should act on the following issues: better collaboration with GP's; an invitation period avoiding holidays; flexible opening hours of the research center to capture the working individuals; the development of age-specific information strategies.