Predictors of Re-participation in Faecal Occult Blood Test-Based Screening for Colorectal Cancer

Abstract

Background: There is little information on longitudinal patterns of participation in faecal occult blood test (FOBT) based colorectal cancer (CRC) screening or on demographic or behavioural factors associated with participation in re-screening. The lack of an agreed system for describing participatory behaviour over multiple rounds also hampers our ability to report, understand and make use of observed associations. Our aims were to develop a system for describing patterns of participatory behaviour in FOBT-based CRC screening programs and to identify factors associated with particular behavioural patterns. Methods: A descriptive framework was developed and applied to a data extract of screening invitation outcomes over two rounds of the NBCSP. The proportion of invitees in each behaviour category was determined and associations between behaviour patterns and demographic and program factors were identified using multivariate analyses. Results: We considered ReParticipants, Dropouts, Late Entrants and Never Participants to be the most appropriate labels for the four possible observed participatory categories after two invitation rounds. The screening participation rate of the South Australian cohort of the NBCSP remained stable over two rounds at 51%, with second round Dropouts (10.3%) being balanced by Late Entrants (10.5%). Non-Participants comprised 38.7% of invitees. Relative to Re-Participants, Dropouts were older, more likely to be female, of lower SES, had changed their place of residence between offers had a positive test result in the first round. Late Entrants tended to be in the youngest age band. Conclusions: Specific demographic characteristics are associated with behavioural sub-groups defined by responses to 2 offers of CRC screening. Targeted group-specific strategies could reduce dropout behaviour or encourage those who declined the first invitation to participate in the second round. It will be important to keep first round participants engaged in order to maximise the benefit of a CRC screening program.

Changes in Colorectal Cancer Screening Knowledge, Behavior, Beliefs, Self- Efficacy, and Barriers among Community Health Clinic Patients after a Health Literacy Intervention

“…Less than half reported that had ever received a physician recommendation for screening or been given an FOBT kit - two of the strongest determinants of screening completion [16,36,40–45]. In each of the study arms patients were given a recommendation for screening and an FOBT kit by study staff.…”

Third Annual Fecal Occult Blood Testing in Community Health Clinics

“…16 Population-based screening programs abroad, where FOBTs are mailed from a country’s centralized public health service, have documented higher repeat FOBT screening rates (39% to 55%). 43–46 …”

Final Results of a 3-Year Literacy-Informed Intervention to Promote Annual Fecal Occult Blood Test Screening

“…Population based screening programs abroad where FOBTs are mailed by centralized health service to eligible individuals have higher repeat FOBT screening rates (39% to 55%) [24-27]. Interestingly, in these programs which eliminate geographic and cost barriers completion rates were lower in individuals from rural areas and those of lower socioeconomic status [28].…”