Abstract

The purpose of bowel cancer screening is to test for signs of cancer before symptoms develop. Financial incentives are one potential method to increase participation rates. Few studies have tested incentives in relation to bowel screening in the United Kingdom (UK). The current research explored reactions to different financial incentives to participate in population-level bowel cancer screening in a UK sample. An online mixed methods study. Recruitment was via a study recruitment website (https://prolific.ac/). 499 participants (aged 60-74 years) completed a survey on invitations for population-level bowel cancer screening using different levels of financial incentives. Respondents were generally positive about the use of financial incentives. A £10 voucher was most frequently selected as the appropriate amount to incentivise screening participation. The current invitation method with no voucher was judged to be most acceptable but suggested to produce the lowest likelihood of others participating. Offering a £10 voucher that the NHS would not be charged for if not used was the second most acceptable invitation method. There were few differences between invitation methods on own perceived likelihood of participation in bowel screening. Offering a £10 voucher was seen as leading to the greatest likelihood of others participating in bowel screening. Findings were largely unaffected by participant demographics. The use of small financial incentives to increase bowel cancer screening uptake was generally well received. Impacts of incentives on actual bowel screening rates in UK samples need to be established in the light of the current findings.

Highlights

  • Cancer screening aims to check the body for cancer before any symptoms develop

  • The most commonly reported positive views were that offering incentives was ‘a good idea’ and that it may save the NHS money in the long run by reducing future treatment costs

  • The proportion of positive, negative and neutral responses did not differ by gender, age group, or socio-economic status (SES) group, they did differ by whether recently screened

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Summary

Introduction

Cancer screening aims to check the body for cancer before any symptoms develop. This can help to diagnose and treat cancer at an early stage (Cancer Research UK, 2021) and contribute to reducing overall mortality. In the United Kingdom, individuals over 60 are invited to the routine bowel cancer screening every two years, but around 30–40% of people do not take part in screening. Research is needed on how best to increase bowel screening rates in the United Kingdom, in groups with low participation rates such as men and individuals from more deprived areas (Cancer Research UK, 2021). The research focussed on perceptions of different types of financial incentives to inform the design of future interventions

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