Abstract

BackgroundColorectal cancer (CRC) screening programmes using a guaiac faecal occult blood test (gFOBt) reduce CRC mortality. Interval cancers are diagnosed between screening rounds: reassurance from a negative gFOBt has the potential to influence the pathway to diagnosis of an interval colorectal cancer.MethodsTwenty‐six semi‐structured face‐to‐face interviews were carried out in Scotland and England, with individuals diagnosed with an interval colorectal cancer following a negative gFOBt result.ResultsParticipants reported they were reassured by a negative gFOBt, interpreting their result as an “all clear”. Therefore, most did not suspect cancer as a possible cause of symptoms and many did not recall their screening result during symptom appraisal. Among those who did consider cancer, and did think about their screening test result, reassurance from a negative gFOBt led some to “downplay” the seriousness of their symptoms with some interviewees explicitly stating that their negative test result contributed to a delayed decision to seek help.ConclusionScreening participants need to be informed of the limitations of screening and the ongoing risk of developing colorectal cancer even when in receipt of a negative result: the importance of minimizing delay in seeking medical advice for colorectal symptoms should be emphasized.

Highlights

  • Colorectal cancer (CRC) screening programmes using a guaiac faecal occult blood test reduce CRC mortality

  • Interval cancers include cancers that have developed between screening rounds and “missed” cancers following a false-­negative screening result; they have poorer survival when compared to screen-­ detected CRC.[12,13,14]

  • The aim of this study was to explore, through individual interviews with screening participants who were diagnosed with an interval colorectal cancer, if receiving a negative screening result in a CRC screening programme contributed to their subsequent response to symptoms potentially indicative of cancer, and their decision to seek medical advice

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Summary

| METHODS

In the UK and other high-­income countries, colorectal cancer (CRC) is a leading cause of cancer-­related mortality.[1,2] Population-­based CRC screening programmes have been introduced in a number of countries and have been shown to reduce CRC mortality.[3] Since 2006, the UK has introduced CRC screening programmes based on the guaiac faecal occult blood test (gFOBt), with colonoscopy offered to those who receive a positive result. The aim of this study was to explore, through individual interviews with screening participants who were diagnosed with an interval colorectal cancer, if receiving a negative screening result in a CRC screening programme contributed to their subsequent response to symptoms potentially indicative of cancer, and their decision to seek medical advice

| Design
| DISCUSSION
Findings
| Strengths and limitations

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