Participation in faecal occult blood screening for colorectal cancer

doi:10.1016/0277-9536(83)90074-6

Social Science & Medicine

Volume 17, Issue 1, 1983, Pages 17-23

https://doi.org/10.1016/0277-9536(83)90074-6 Get rights and content

Abstract

Chemical faecal occult blood testing has been proposed as a means of screening for colorectal cancer (C.C.) in populations or in identified high-risk groups. The level of public participation is a critical factor in the effectiveness of screening programmes. This study was conducted as a methodological pretest for an intended investigation of factors influencing screening participation. Faecal occult blood screening was offered to 728 employees of a teaching hospital in Sydney, New South Wales and 41% participation was obtained. Both participants and non-participants were questioned on demographic and social background factors, on their experience of C.C. in others, and on their reasons for participating or not participating. Major reasons for participation were: a general feeling of the importance of health checks and screening tests; a belief that it is important to diagnose C.C. early; and the fact that the test was simple and easy to do. Prominent self-acknowledged reasons for non-participation were indifference, procrastination, absence of previous bowel complaints, preference for one's own doctor to do such tests and inconvinience or lack of time. Those more likely to participate were: females; those of Australian or British origin; single, separated or divorced persons; those having two or more dependents and those with personal knowledge of a C.C. patient.

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Cited by (51)

Factors associated with adherence to fecal occult blood testing for colorectal cancer screening among adults in the Republic of Korea
2014, European Journal of Oncology Nursing
Citation Excerpt :
This is also the case among various ethnic groups (e.g., Australians, Chinese–Americans, and the French). Adults have frequently reported worries or fears of positive test results (i.e., indicating cancer) as one of the main reasons for avoiding FOBT (Dent et al., 1983; Sun et al., 2004; Vernon, 1997). Another important issue to consider in this study is the non-significant effects of self-efficacy and perceived benefits.
Repeated participation in fecal occult blood testing (FOBT) is one of the major factors affecting the long-term success of population-based colorectal cancer screening programs. The aim of this study is to explore strong factors linked to repeated participation in FOBT in the prior decade (2002–2011) among adults using the Health Belief Model (HBM) after controlling for other covariates.
Data were obtained from South Korean adults, aged 50 years and over, who visited a national health screening center within a magnet hospital (N = 237). A pilot test was conducted to investigate the internal consistency of the HBM instruments and the clarity of survey questions. Sample characteristics and rates of adherence to FOBT screening were examined using means and frequencies. Important factors associated with adherence to FOBT were examined using multivariate logistic regression analysis.
About 44% of the respondents were adherent to FOBT screening over the prior decade. Four out of the six HBM-driven factors (perceived susceptibility, severity, and barriers, and health motivation) were statistically significant. Those with greater levels of susceptibility and health motivation and lower levels of severity and barriers were more likely to adhere to FOBT.
Health professionals should focus more on the four modifiable HBM-related factors to encourage adults to adhere to FOBT. Intervention programs, which lower perceived severity and barriers and increase susceptibility and health motivation, should be developed and implemented.
What affects the uptake of screening for bowel cancer using a faecal occult blood test (FOBt): A qualitative study
2008, Social Science and Medicine
Citation Excerpt :
Survival rates are higher when the disease is detected early, and screening with the Faecal Occult Blood test (FOBt) can reduce bowel cancer mortality by 16% (Hewitson, Glasziou, Irwig, Towler, & Watson, 2007). Several studies in the United States (Beeker, Kraft, Southwell, & Jorgensen, 2000; O'Malley, Beaton, Yabroff, Abramson, & Mandelblatt, 2004; Wackerbath, Peters, & Haist, 2005), Australia (Clavarino et al., 2004; Dent, Bartrop, Goulston, & Chapuis, 1983; Worthley et al., 2006) and Europe (Rossi et al., 2005) have identified factors that may influence people's decisions about whether to take part in screening for bowel cancer. Research done in other countries can help us to understand why people make screening decisions, but researchers and policy makers should remember that screening strategies elsewhere may differ.
Screening can reduce bowel cancer mortality. The UK National Health Service Bowel Cancer Screening Programme (NHS BCSP), using the Faecal Occult Blood test (FOBt), is being introduced over three years in the UK, but in some areas uptake is disappointing. We sought to understand why some people decided to participate in screening for bowel cancer while others did not. Interviews were conducted with 44 men and women invited for screening. Most had decided to take part, some were reluctant, and a few had declined to participate. We aimed for a maximum variation sample. Reasons for accepting screening included: knowing someone with cancer, previous positive experience of women's screening programmes, being a “good citizen”, previous bowel problems, and encouragement from others. Reasons for reluctance to take part included: feeling healthy, fear of outcome, lack of time, disgust at the idea of handling stools, concern about posting samples in the mail, misunderstanding instructions, and past (negative) experience or fear of colonoscopy. Theoretical models of health behaviours do not mention the sense of civic responsibility that encourages people to avert (later) costs to the NHS. This may be a particular feature of a socialized health system. Our results also suggest that people might feel more inclined to accept screening if they had current information about patients' experiences of colonoscopy and treatment for early bowel cancer.
Factors associated with colorectal cancer screening among Chinese-Americans
2004, Preventive Medicine
Objective. To investigate factors associated with receipt of colorectal cancer (CRC) screening among urban senior Chinese-Americans.
Methods. Two hundred three men and women from three senior centers completed a questionnaire that included sections on demographics, fecal occult blood testing (FOBT) and sigmoidoscopy use, and potential barriers to screening.
Results. Receipt of a FOBT within the prior 12 months (37.9% of sample) was associated with fewer years of US residency, lower level of worries or fears of test results, and higher level of perceived susceptibility to CRC. Receipt of a flexible sigmoidoscopy within the past 5 years (22.2% of sample) was associated with higher levels of education, lower levels of worries or fears of test results, and higher level of perceived susceptibility of CRC.
Conclusions. Intervention programs may target these areas to facilitate CRC screening in Chinese-Americans so that national goals can be met for all Americans.
Colorectal cancer screening with flexible sigmoidoscopy - Participants' experiences and technical feasibility
2004, European Journal of Surgical Oncology
Aim. To evaluate tolerability and technical feasibility of colorectal cancer screening with flexible sigmoidoscopy.
Methods. One thousand men and women aged 59–61 years, randomly selected from the population register of Uppsala, Sweden, were invited by mail. After random allocation, half of them were called up by a nurse (group 1), while the other half were asked to call themselves (group 2) to book a sigmoidoscopy. After the examination, the participants anonymously answered a questionnaire about their subjective experiences. Endoscopists and their assisting nurse filled out structured forms documenting various technical aspects including an estimation of the subjects' discomfort.
Results. Four hundred and sixty-nine subjects participated. Mean intubation depth was 59 cm (range 28–60) and mean duration 5.8 min (range 2–23). On average, participants reported low degrees of discomfort and feeling of exposure, but 19 and 27% rated pain and distension, respectively, on the upper half of a visual analogue scale (VAS). Most subjects found the duration acceptable. Patient discomfort, as appraised by the endoscopists, was lower in men than in women, positively linked to duration of the procedure, but inversely associated with intubation distance. However, the overall differences between strata of participants were small. Among self-reported variables, group 1 and 2 differed significantly only with regard to ‘other discomfort’. All but six subjects would accept a repeat examination. Failures, resulting in incomplete examinations, occurred in 14 subjects.
Conclusions. Flexible sigmoidoscopy is generally well tolerated and technically feasible in screening for colorectal cancer. A more personalised invitation did not have any important effects on the subjective experience.
Cancer surveillance in ulcerative colitis: Critical analysis of long-term prospective programme
2002, Digestive and Liver Disease
Background. Patients with longstanding ulcerative colitis are at increased risk of colorectal cancer. In the literature, no agreement has yet been reached regarding prevention strategies. Our report sums up a prospective study started in 1980.
Methods. A total of 65 patients affected by ulcerative colitis for more than seven years were admitted to a regular colonoscopic and biopsy follow-up programme.
Results. Some 20 years after the beginning of the study, 23 (35.3%) patients have been operated upon, 2 patients have died but not from cancer, 29 (44.6%) patients have abandoned the programme. Only 11 (16.9%) patients have remained under colonoscopic surveillance.
Conclusion. These results cast some doubts on the significance of such a programme and on its long-term feasibility.
Promoting cancer screening among the first-degree relatives of breast and colorectal cancer patients: The design of two randomized trials
1999, Preventive Medicine
Background.In this paper two large nationwide trials are described, both of which will test a comparable telephone-based counseling intervention to promote cancer screening among the first-degree relatives (FDRs) of breast and colorectal cancer patients. The unit of randomization will be the family unit of eligible FDRs. Access to FDRs will be obtained from their relatives with cancer. Selected intervention and design issues are reviewed, including how both projects will respond to FDRs who exhibit significant levels of cancer-specific anxiety or distress and how potential high-risk cancer families will be accommodated.
Methods.Pursuant to the development of both studies, two feasibility surveys were conducted to determine whether patients would grant access to their FDRs and whether the FDRS identified by these patients would be receptive to the telephone intervention.
Results.Approximately 80% (106 of 132) of breast cancer patients agreed to provide access to their eligible FDRs when contacted on-site at participating hospitals and clinics. Of those subsequently selected for telephone follow-up (n= 95 or 90%), 80% (n= 76) were successfully contacted by telephone, and of these 97% (n= 74) provided the names and telephone numbers of their FDRs. Among colorectal cancer patients contacted on-site (n= 46), 96% (n= 44) agreed to provide access to their FDRs, and of those contacted by telephone (n= 33 or 75%), 91% (n= 30) provided the requested information about their FDRs. Once contacted, 95% of breast cancer FDRs (55 of 58) and 91% of colorectal cancer patients (51 of 56) endorsed the intervention strategy.
Conclusions.It is argued that this intervention, if proven effective, could provide an exportable strategy for reaching large numbers of high-risk individuals to promote cancer screening.

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Participation in faecal occult blood screening for colorectal cancer

Abstract

Am. J. Surg.

Prev. Med.

Soc. Sci. Med.

Communit. Hlth Stud.

large bowel cancer—the next move?

Med. J. Aust.

Results of treatment of carcinoma of the colon and rectum

Management and survival of carcinoma of the colon: results of a national survey by the American College of Surgeons

Ann. Surg.

Screening for colorectal cancer: an overview

Cancer

Progress report on controlled trial of faecal occult blood testing for the detection of colorectal neoplasia

Cancer

Screening for symptomless colorectal cancer by testing for occult blood in general practice

Lancet

Hemoccult screening for colorectal neoplasms: report of a pilot project

Wisc. Med. J.