• Katina D'Onise, Emilia Tiziana Iacobini, and Karla Joy Canuto.
• Prevention and Population Health Directorate, Wellbeing SA, Citi Centre Building, 11 Hindmarsh Square, Adelaide, South Australia, Australia. Electronic address: Katina.D'Onise@sa.gov.au.
• Prev Med. 2020 May 1; 134: 106018.

ObjectiveColorectal cancer (CRC) screening using a Faecal Occult Blood Test (FOBT) is a well-established population intervention to reduce mortality and morbidity of CRC. As Indigenous people are not fully benefiting from the screening programs, a greater understanding of barriers and enablers affecting participation is needed.MethodsSearches were carried out in PubMed, Embase, Sociological Abstracts, Scopus, CINAHL, and selected websites. Both qualitative and quantitative studies related to Indigenous populations of Canada, New Zealand, Australia and the United States of America were assessed for quality and data related to FOBT were extracted and synthetised.ResultsA total of 375 publications were identified and screened against the inclusion/exclusion criteria. Thirty-four studies were included in the review. The barriers for participation in CRC screening included the lack of culturally competent health service access, particularly access to Indigenous health service providers. Medical discrimination, long-standing distrust in Western medicine and/or health staff and screening tests were all identified as barriers for Indigenous people. There were a small number of promising interventions to improve participation, which could be considered on a broader scale to increase overall participation by Indigenous people in CRC screening.ConclusionsThe review identified barriers and possible enablers for Indigenous participation in the CRC screening program, some which appear to be unique to Indigenous people. Further intervention studies conducted in partnership with Indigenous communities are needed to improve participation.Copyright © 2020 Elsevier Inc. All rights reserved.

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