POSB341 Participants' Motivation for Colorectal Cancer Screening in Japan: A Secondary Qualitative Study

Abstract

Although colorectal cancer screening has been provided as a national program in Japan, the participation rate has remained lower than in other OECD countries. While several strategies for improving participation in cancer screening have been promoted in Japan, participants’ motivation for undertaking cancer screening has rarely been examined. To investigate participants’ reasons for attending colorectal cancer screening in Japan, a secondary qualitative study was conducted by using the Database of Individual Patient Experience Japan（https://www.dipex-j.org/about/). Colorectal cancer patients or participants in colorectal cancer screening were purposefully sampled from the archive. The subjects were either involved in primary screening or work-up exams, which were included for analysis. Individuals with a disability, hereditary disease, or symptomatic outpatients were excluded because they were not targeted for colorectal cancer screening. A thematic analysis was performed on transcripts of the selected subjects. Emerging codes and themes were inductively categorized, and individual motivations were examined by mapping the linkage of these emerging topics. In total, 22 cases were selected for analysis from the database involving 35 subjects. Of eighteen patients who talked about their experience of primary screening, fifteen patients attended the screening. Many of them decided to take part in the screening because of their screening history, and several patients felt their participation was an obligation. Another twelve patients mentioned that they were recommended to receive a work-up exam by doctors due to their FOBT-positive Results: Six out of the twelve patients rejected the suggestion because they did not feel obligated but prioritized their time at work. Participants’ knowledge and their screening history were related to motivation for colorectal cancer screening. The seriousness with which patients received physician’s suggestions regarding cancer screening greatly varied. It is imperative to understand how patients perceive the risk and benefit of cancer screening or work-up examination.