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Declining the offer of flexible sigmoidoscopy screening for bowel cancer: : a qualitative investigation of the decision-making process

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  • McCaffery, Kirsten
  • Borril, Jo
  • Williamson, Sara
  • Taylor, Tamara
  • Sutton, Stephen
  • Atkin, Wendy
  • Wardle, Jane

Abstract

Qualitative methods were used to investigate decision-making among a group of older adults who declined the offer of flexible sigmoidoscopy screening for bowel cancer. Interviews were conducted with 60 people (30 men and 30 women) who either had not responded to the screening letter or who responded saying that they were not interested in participating. The findings suggest that low perceived susceptibility to bowel cancer, in terms of current health status, family history or absence of bowel symptoms, was an important factor in the decision to decline screening. Procedural barriers such as embarrassment, pain/discomfort and perceived unpleasantness of the test were reported as relatively minor, although the test was considered more physically intrusive than other screening tests. Avoidant attitudes emerged as an important theme and were reported by a third of respondents. Distinct patterns of decision-making were also observed and three groups emerged from accounts: (i) forgetting or avoiding making a decision about the test (ii) a confident rejection of the test based on a few salient factors, and (iii) a more careful consideration of the test focusing on issues of susceptibility. The findings are discussed in the context of models of health behaviour and bowel cancer screening participation research.

Suggested Citation

  • McCaffery, Kirsten & Borril, Jo & Williamson, Sara & Taylor, Tamara & Sutton, Stephen & Atkin, Wendy & Wardle, Jane, 2001. "Declining the offer of flexible sigmoidoscopy screening for bowel cancer: : a qualitative investigation of the decision-making process," Social Science & Medicine, Elsevier, vol. 53(5), pages 679-691, September.
  • Handle: RePEc:eee:socmed:v:53:y:2001:i:5:p:679-691
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    Cited by:

    1. Le Bonniec, Alice & Meade, Oonagh & Fredrix, Milou & Morrissey, Eimear & O'Carroll, Ronan E. & Murphy, Patrick J. & Murphy, Andrew W. & Mc Sharry, Jenny, 2023. "Exploring non-participation in colorectal cancer screening: A systematic review of qualitative studies," Social Science & Medicine, Elsevier, vol. 329(C).
    2. Beyer, Kirsten M.M. & Comstock, Sara & Seagren, Renea & Rushton, Gerard, 2011. "Explaining place-based colorectal cancer health disparities: Evidence from a rural context," Social Science & Medicine, Elsevier, vol. 72(3), pages 373-382, February.
    3. Schmeising-Barnes, Ninian & Waller, Jo & Marlow, Laura A.V., 2024. "Attitudes to multi-cancer early detection (MCED) blood tests for population-based screening: A qualitative study in Great Britain," Social Science & Medicine, Elsevier, vol. 347(C).
    4. Chapple, Alison & Ziebland, Sue & Hewitson, Paul & McPherson, Ann, 2008. "What affects the uptake of screening for bowel cancer using a faecal occult blood test (FOBt): A qualitative study," Social Science & Medicine, Elsevier, vol. 66(12), pages 2425-2435, June.
    5. Martin C S Wong & Jessica Y L Ching & Hoyee H Hirai & Thomas Y T Lam & Sian M Griffiths & Francis K L Chan & Joseph J Y Sung, 2013. "Perceived Obstacles of Colorectal Cancer Screening and Their Associated Factors among 10,078 Chinese Participants," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.

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