Abstract
BackgroundColorectal cancer screening is key to early detection and thus to early treatment, but uptake is often sub-optimal, particularly amongst lower income groups. It is proposed that the imminent introduction of the single-sample Faecal Immunochemical Test (FIT) in Scotland may lead to increased uptake as compared to the current Faecal Occult Blood Test (FOBT), but underlying reasons are yet to be determined. The aim was to evaluate attitudes and intentions towards completing the FIT compared to the current FOBT for colorectal cancer screening.MethodsA convenience sample of 200 adults (mean age 56.5, range 40–89; 59 % female) living in Scotland rated both the FOBT and the FIT with regard to ease of completion, perceived disgust and intention to complete and return (all measured on Likert-type 1–7 scale). Participants were randomised to be presented (via a face-to-face contact) with either the FIT or FOBT first.ResultsParticipants reported higher intention to complete and return the FIT versus the FOBT (mean difference 0.62, 95 % CI (0.44, 0.79)). Overall, 85.0 % (n = 170) of participants agreed or strongly agreed that they would intend to complete and return the FIT compared to 65.5 % (n = 131) for the FOBT (χ2 = 20.4, p < .001). The FIT was also perceived to be easier to complete (mean difference 0.85, 95 % CI (0.70, 1.01) and much less disgusting (mean difference 1.11, 95 % CI (0.94, 1.27)). Lower perceived disgust, higher socio-economic status and previous participation in any cancer screening were significant predictors of intention to complete the FOBT, whilst only higher perceived ease of completion predicted intention to complete the FIT.ConclusionsPeople reported higher intentions to complete and return a FIT than a FOBT test for colorectal cancer screening, largely due to a perception that it is easier and less disgusting to complete. The findings suggest that the introduction of the FIT as standard in the UK could result in a notable increase in screening uptake.
Highlights
Colorectal cancer screening is key to early detection and to early treatment, but uptake is often sub-optimal, amongst lower income groups
A recent pilot of the Faecal Immunochemical Test (FIT) indicated that introduction of this as the first line screening test is likely to increase colorectal screening uptake compared to the guaiac Faecal Occult Blood Test (FOBT) which is currently used in the Scottish National Screening Programme [3]
It was hypothesised that the FIT would be perceived as less disgusting and easier to complete than the FOBT due to the new method and materials provided in the screening kit, and the elimination of the need to keep samples in the house over the testing period of up to ten days
Summary
Colorectal cancer screening is key to early detection and to early treatment, but uptake is often sub-optimal, amongst lower income groups. It is proposed that the imminent introduction of the single-sample Faecal Immunochemical Test (FIT) in Scotland may lead to increased uptake as compared to the current Faecal Occult Blood Test (FOBT), but underlying reasons are yet to be determined. The aim was to evaluate attitudes and intentions towards completing the FIT compared to the current FOBT for colorectal cancer screening. Screening aims to detect colorectal cancer at an early stage, in people with no symptoms, and can detect non-cancerous polyps and adenomas which could develop into cancer over time, which can be removed and reduce the risk of cancer developing. The Faecal Occult Blood Test (FOBT) is sent out by post for individuals to complete at home and post back to the National Bowel Screening Centre. Once all 6 windows are completed, cards are posted back to the screening centre where they are tested for hidden traces of blood
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