Why colorectal screening fails to achieve the uptake rates of breast and cervical cancer screening : a comparative qualitative study
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Background In Scotland, the uptake of clinic-based breast (72%) and cervical (77%) screening is higher than home-based colorectal screening (~60%). To inform new approaches to increase uptake of colorectal screening, we compared the perceptions of colorectal screening among women with different screening histories. Methods We purposively sampled women with different screening histories to invite to semistructured interviews: (1) participated in all; (2) participated in breast and cervical but not colorectal (‘colorectal-specific non-participants’); (3) participated in none. To identify the sample we linked the data for all women eligible for all three screening programmes in Glasgow, Scotland (aged 51–64 years; n=68 324). Interviews covered perceptions of cancer, screening and screening decisions. Framework method was used for analysis. Results Of the 2924 women invited, 86 expressed an interest, and 59 were interviewed. The three groups’ perceptions differed, with the colorectal-specific non-participants expressing that: (1) treatment for colorectal cancer is more severe than for breast or cervical cancer; (2) colorectal symptoms are easier to self-detect than breast or cervical symptoms; (3) they worried about completing the test incorrectly; and (4) the colorectal test could be more easily delayed or forgotten than breast or cervical screening. Conclusion Our comparative approach suggested targets for future interventions to increase colorectal screening uptake including: (1) reducing fear of colorectal cancer treatments; (2) increasing awareness that screening is for the asymptomatic; (3) increasing confidence to self-complete the test; and (4) providing a suggested deadline and/or additional reminders.
Kotzur , M , McCowan , C , Macdonald , S , Wyke , S , Gatting , L , Campbell , C , Weller , D , Crighton , E , Steele , R & Robb , K 2019 , ' Why colorectal screening fails to achieve the uptake rates of breast and cervical cancer screening : a comparative qualitative study ' , BMJ Quality & Safety , vol. Online First . https://doi.org/10.1136/bmjqs-2019-009998
BMJ Quality & Safety
Copyright © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ. This work has been made available online in accordance with publisher policies or with permission. Permission for further reuse of this content should be sought from the publisher or the rights holder. This is the author created accepted manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at https://doi.org/10.1136/bmjqs-2019-009998
DescriptionFunding: National Awareness and Early Diagnosis Initiative Grant (C9227/A17676) awarded to co-PIs KR and CMcC.
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