Why colorectal screening fails to achieve the uptake rates of breast and cervical cancer screening: a comparative qualitative study.

Abstract:

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.

journal_name

BMJ Qual Saf

journal_title

BMJ quality & safety

authors

Kotzur M,McCowan C,Macdonald S,Wyke S,Gatting L,Campbell C,Weller D,Crighton E,Steele RJC,Robb KA

doi

10.1136/bmjqs-2019-009998

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

482-490

issue

6

eissn

2044-5415

issn

2044-5423

pii

bmjqs-2019-009998

journal_volume

29

pub_type

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