Patients’ views on involving general practice in bowel cancer screening: a South Australian focus group study

Abstract

ObjectivesTo explore patients’ experiences of bowel cancer screening and its promotion, and perspectives on possible input from general practice for improving screening rates.DesignQualitative focus group study underpinned by a phenomenological approach.SettingThree general practice clinics in metropolitan South Australia.ParticipantsThirty active general practice patients, aged 50–74 years (60% female) who were eligible for the National Bowel Cancer Screening Program.FindingsFactors affecting screening were described, with particular concerns regarding the nature of the test, screening process and culture. There were mixed views on the role for general practice in bowel cancer screening; some participants appreciated the current process and viewed screening as out of scope of primary care services, while others were in support of general practice involvement. Roles for general practice were proposed that comprised actions across the continuum from providing information through to reminders and the provision and collection of screening kits. With a view that multifaceted strategies are required to encourage participation, community-based solutions were suggested that centred on improving screening culture and education.ConclusionsThere was a view among participants that general practice could play a useful role in supporting the uptake of the National Bowel Cancer Screening Program, however participants saw a need for multiple strategies at different levels and under different jurisdictions.

Development and psychometric evaluation of the Aversion to Bowel Cancer Screening Scale

“…Individuals identifying as female and of Caucasian background were overrepresented in our sample. This may represent a potential caveat to the interpretation of the current findings with females exhibiting better screening participation rates (Brown et al, 2020), reporting different emotional barriers to screening (Clarke et al, 2016;Friedemann-Sanchez et al, 2007) and generally reporting higher disgust (Druschel & Sherman, 1999;Rohrmann et al, 2008). Similarly, research has also indicated that ethnic groups experience different barriers to CRC screening and poorer uptake (e.g., Christou & Thompson, 2012) and, for example, variation in CRC screening embarrassment (Consedine et al, 2011); embarrassment deterring discussion of bowel symptoms (Keighley et al, 2004); fear of results, complications and procedures (Brenner et al, 2015); and disgust deterring fecal collection (Dharni et al, 2017).…”

“…Low public awareness, low perceived risk and lack of general practitioner endorsement are commonly identified as prominent barriers to screening participation (Benito et al, 2018 ; Brown et al, 2020 ; Honein‐AbouHaidar et al, 2016 ). More recently, the emotions involved in CRC screening decision‐making have been identified, including fear, embarrassment and disgust.…”

How do women comply with cancer screenings? A study in four regions of France

“…Participants in a single OS had an intermediate response rate and non-participants responded little. The difficulty in reaching non-participants was not unexpected, as they are also often unwilling to discuss the matter [ 17 ].…”

Increasing bowel cancer screening using SMS in general practice: the SMARTscreen trial.

“…Effective interventions to increase screening uptake include: endorsement of CRC screening by a general practitioner (GP) [6][7][8] , TV public service announcement campaigns featuring relatable people discussing their personal screening experience 9 , and providing practical easy-to-follow instructions about completing the NBCSP kit 10,11 . SMS has been demonstrated to have an impact on screening uptake with first-time screeners in the UK 12 , and in Alaska Native and American Indian people 13 .…”