Reasons for participation and non-participation in colorectal cancer screening

Berg‐Beckhoff, Gabriele; Leppin, Anja; Nielsen, Jesper Bo

doi:10.1016/j.puhe.2022.01.010

Cited by 11 publications

(4 citation statements)

References 23 publications

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“…Their own self‐view as healthy and able to address their AF risk if symptoms arose, or mediate this risk through existing health practices, matches nonparticipation decisions in other screening programmes (e.g., Chapple et al; Chien et al). 52 , 53 In this context, echoing concerns of other nonparticipants across screening programmes (e.g., Berg‐Beckhoff et al; Maclean et al), 54 , 55 engaging in screening risked ‘making’ AF and opening Pandora's box of ‘trouble’. This was not irrational: testing for a condition they did not think they had (but that they recognised could be identified by screening) would create unhelpful awareness of problems in their body and disrupt their health.…”

Section: Discussionmentioning

confidence: 98%

“…50,51 From the evidence presented to them, interviewees accepted that AF was a serious condition and, referencing appreciation of preventative healthcare, thought screening a useful opportunity to address this risk for others. 54,55 engaging in screening risked 'making' AF and opening Pandora's box of 'trouble'. This was not irrational: testing for a condition they did not think they had (but that they recognised could be identified by screening) would create unhelpful awareness of problems in their body and disrupt their health.…”

Section: Box 2 Summary Of Interview Topic Guidementioning

confidence: 99%

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Why do people choose not to take part in screening? Qualitative interview study of atrial fibrillation screening nonparticipation

Hoare

Thomas

Powell

et al. 2023

Health Expectations

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IntroductionWhile screening uptake is variable, many individuals feel they ‘ought’ to participate in screening programmes to aid the detection of conditions amenable to early treatment. Those not taking part in screening are often presented as either hindered by practical or social barriers or personally at fault. Why some people choose not to participate receives less consideration.MethodsWe explored screening nonparticipation by examining the accounts of participants who chose not to participate in screening offered by a national research trial of atrial fibrillation (AF) screening in England (SAFER: Screening for Atrial Fibrillation with ECG to Reduce stroke). AF is a heart arrhythmia that increases in prevalence with age and increases the risk of stroke. Systematic screening for AF is not a nationally adopted programme within the United Kingdom; it provides a unique opportunity to explore screening nonparticipation outside of the norms and values attached to existing population‐based screening programmes. We interviewed people aged over 65 (n = 50) who declined an invitation from SAFER and analysed their accounts thematically.ResultsBeyond practical reasons for nonparticipation, interviewees challenged the utility of identifying and managing AF earlier. Many questioned the benefits of screening at their age. The trial's presentation of the screening as research made it feel voluntary—something they could legitimately decline.ConclusionNonparticipants were not resistant to engaging in health‐promoting behaviours, uninformed about screening or unsupportive of its potential benefits. Instead, their consideration of the perceived necessity, legitimacy and utility of this screening shaped their decision not to take part.Patient or Public ContributionThe SAFER programme is guided by four patient and carer representatives. The representatives are embedded within the team (e.g., one is a co‐applicant, another sits on the programme steering committee) and by participating in regular meetings advise on all aspects of the design, management and delivery of the programme, including engaging with interpreting and disseminating the findings. For the qualitative workstream, we established a supplementary patient and public involvement group with whom we regularly consult about research design questions.

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Section: Discussionmentioning

confidence: 98%

Section: Box 2 Summary Of Interview Topic Guidementioning

confidence: 99%

Why do people choose not to take part in screening? Qualitative interview study of atrial fibrillation screening nonparticipation

Hoare

Thomas

Powell

et al. 2023

Health Expectations

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“…The decision to include the option for recipients to request a new test kit was based on previous research exploring reasons for not completing an FIT screening kit, which documents one of the reasons as having 'misplaced' or 'lost' the kit. 17…”

Section: Open Accessmentioning

confidence: 99%

Comparing the effectiveness and cost-effectiveness of text-message reminders and telephone patient navigation to improve the uptake of faecal immunochemical test screening among non-responders in London: a randomised controlled trial protocol

Duffy,

Gil,

Siddique

et al. 2024

BMJ Open

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IntroductionParticipation in bowel cancer screening is lower in regions where there is high ethnic diversity and/or socioeconomic deprivation. Interventions, such as text message reminders and patient navigation (PN), have the potential to increase participation in these areas. As such, there is interest in the comparative effectiveness of these interventions to increase bowel cancer screening participation, as well as their relative cost-effectiveness.Methods and analysisThis study will use a three-arm randomised controlled trial design to compare the effectiveness and cost-effectiveness of text message reminders and PN to increase the uptake of bowel cancer screening in London. Participants will be individuals who have not returned a completed faecal immunochemical test kit within 13 weeks of receiving a routine invitation from the London bowel cancer screening hub. Participants will be randomised (in a 1:1:1 ratio) to receive either (1) usual care (ie, ‘no intervention’), (2) a text message reminder at 13 weeks, followed by repeated text message reminders at 15, 17 and 19 weeks (in the event of non-response) or (3) a text message reminder at 13 weeks, followed by PN telephone calls at 15, 17 and 19 weeks in the event of non-response. The primary endpoint will be participation in bowel cancer screening, defined as ‘the return of a completed kit by week 24’. Statistical analysis will use multivariate logistic regression and will incorporate pairwise comparisons of all three groups, adjusted for multiple testing.Ethics and disseminationApprovals to conduct the research have been obtained from University College London’s Joint Research Office (Ref: 150666), the Screening Research, Innovation and Development Advisory Committee (‘RIDAC’, Ref: 2223 014 BCSP Kerrison), the Health Research Authority (Ref: 22/WM/0212) and the Confidentiality Advisory Group (Ref: 22/CAG/0140). Results will be conveyed to stakeholders, notably those managing the screening programme and published in peer-reviewed journals/presented at academic conferences.Trial registration numberISRCTN17245519

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“…In the signi cant literature, studies examining CRC screening behaviors report that a wide variety of factors are effective in participating in CRC screenings. Socio-demographic variables (age, gender, educational status, employment status, and income level), the individual's health insurance, some health beliefs about screenings, the level of knowledge about screenings, high level of awareness, and the recommendation of screening tests by the physician are the factors that are suggested to be effective in CRC screening behaviors [11][12][13][14][15][16][17]. Determining the factors that are thought to in uence participation in CRC screenings is of great importance in order to plan effective interventions that can be used to increase screening behaviors in risky individuals and to structure the interventions within this framework.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Stages of Adoption for Colorectal Cancer Screening Among Primary Care Patients in Turkey

Dönmez

TOPTANER

Ata

et al. 2023

Preprint

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Purpose Although colorectal cancer (CRC) screening programs are known and recommended for reducing the mortality and morbidity rates from CRC, the adherence rates for the fecal occult blood test (FOBT) and colonoscopy are low among adult individuals. Moreover, CRC screening behaviors of primary health care patients remain largely unknown. The purpose of this study was to examine the predictors of stages of adoption for CRC screening in primary health care patients. Methods This cross-sectional study was carried out in primary health care centers with 498 adults between the ages of 50 and 70 years. The data were collected using the “Descriptive Form” and the “Instruments to Measure CRC Screening Benefits and Barriers.” Results The results indicate that colonoscopy was better known compared to FOBT, and information sources of screening tests were mostly relatives and family physicians. Most participants were at the precontemplation stage. Education level, employment status, income level, health status, having a patient diagnosed with CRC in the family, and having information about screening were related to the perception of benefits of having a FOBT and colonoscopy. On the other hand, adherence to colonoscopy, lack of knowledge about screening, and provider recommendation were related to perceived barriers. In addition, perceived benefits and barriers were predictive factors of earlier stages of adoption for FOBT and colonoscopy. Conclusion The results of the study demonstrate that primary care providers have crucial roles for increasing CRC screening in the community. Interventions to improve screening adherence rates should be tailored to individuals in particular stages of adoption for CRC screening.

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Reasons for participation and non-participation in colorectal cancer screening

Cited by 11 publications

References 23 publications

Why do people choose not to take part in screening? Qualitative interview study of atrial fibrillation screening nonparticipation

Why do people choose not to take part in screening? Qualitative interview study of atrial fibrillation screening nonparticipation

Comparing the effectiveness and cost-effectiveness of text-message reminders and telephone patient navigation to improve the uptake of faecal immunochemical test screening among non-responders in London: a randomised controlled trial protocol

Predictors of Stages of Adoption for Colorectal Cancer Screening Among Primary Care Patients in Turkey

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