Abstract
The NHS Bowel Cancer Screening Programme (BCSP) is aimed at reducing colorectal cancer (CRC) mortality through early detection within a healthy population. This study explores how 5 people (three females) experience and make sense of their screen-detected diagnosis and the psychological implications of this diagnostic pathway. A biographical narrative interview method was used, and transcripts were analysed using a thematic analysis with a phenomenological lens. Themes specifically relating to posttreatment experience and reflections are reported here: Do it: being living proof, Resisting the threat of recurrence, Rationalising bodily change, and Continuing life—“carrying on normally.” Participants described their gratefulness to the BCSP, motivating a strong desire to persuade others to be screened. Furthermore, participants professed a duality of experience categorised by the normalisation of life after diagnosis and treatment and an identification of strength post cancer, as well as a difficulty adjusting to the new changes in life and a contrasting identity of frailty. Understanding both the long- and short-term impacts of a CRC diagnosis through screening is instrumental to the optimisation of support for patients. The results perhaps highlight a particular target for psychological distress reduction, which could reduce the direct and indirect cost of cancer to the patient.
Highlights
Colorectal cancer (CRC) is the second most common cause of cancer death in the UK; it is one of the most treatable cancers if detected early [1,2,3]
We review the events, descriptions, and reflections encased within the individual, personal stories of those previously diagnosed with CRC through the National Health Service (NHS) Bowel Cancer Screening Programme (BCSP)
Having experienced the initial shock of diagnosis, participants expressed passionate feelings about guaiac faecal occult blood test (gFOBt) completion, considering it to be something which had saved their lives: this we understood from their primary expression of feeling “lucky.” They felt highly motivated to persuade other people to carry out the test
Summary
Colorectal cancer (CRC) is the second most common cause of cancer death in the UK; it is one of the most treatable cancers if detected early [1,2,3]. In 2006, the English National Health Service (NHS) introduced a population-based screening programme to help reduce CRC mortality. The Bowel Cancer Screening Programme (BCSP) invites men and women aged 60–74, and registered with a general practice in England, to complete a guaiac faecal occult blood test (gFOBt) at home, every two years. Blood in a stool sample could be a sign of bowel cancer and so, if present, a follow-up endoscopic test (i.e., colonoscopy) is offered to determine the cause of the bleed and to initiate the necessary treatment [4]. A Cochrane review by Hewitson and colleagues found that taking part in gFOBt screening can reduce CRC mortality by up to 25% [5]
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