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

Kotzur, M. , McCowan, C. , Macdonald, S. , Wyke, S. , Gatting, L., Campbell, C., Weller, D., Crighton, E., Steele, R. J.C. and Robb, K. A. (2020) Why colorectal screening fails to achieve the uptake rates of breast and cervical cancer screening: a comparative qualitative study. BMJ Quality and Safety, 29, pp. 482-490. (doi: 10.1136/bmjqs-2019-009998) (PMID:31879320)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wyke, Professor Sally and Mccowan, Professor Colin and Gatting, Ms Lauren and Robb, Dr Katie and Macdonald, Dr Sara and Kotzur, Dr Marie
Authors: Kotzur, M., McCowan, C., Macdonald, S., Wyke, S., Gatting, L., Campbell, C., Weller, D., Crighton, E., Steele, R. J.C., and Robb, K. A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
Journal Name:BMJ Quality and Safety
Publisher:BMJ Publishing Group
ISSN:2044-5415
ISSN (Online):2044-5423
Published Online:26 December 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in BMJ Quality and Safety 29:482-490
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190869What can we learn about how to improve uptake of bowel cancer screening from higher rates of uptake in breast and cervical screening programmes?Kathryn RobbCancer Research UK (CRUK)C9227/A17676HW - Mental Health and Wellbeing