Factors affecting compliance with screening for colorectal cancer

Abstract

A recently developed faecal occult blood test can be used to screen apparently well people for large bowel cancer. One of the principal influences on how much benefit this might achieve is its acceptability to middle-aged people. The characteristics of acceptors and non-acceptors of the test were compared in this study which prospectively explored people's attitudes and beliefs in an interview before they were sent the test, and re-interviewed them six weeks later. Acceptance was constant at 50–55 per cent in those aged under 65 but fell thereafter, but there was no evidence of a social class trend. The acceptors were more likely to have positive attitudes towards preventive health practices and to have had more recent contacts with medical services. They were better informed about serious illnesses and were more optimistic and less frightened about cancer. However, there were no significant differences between acceptors and non-acceptors in the prevalence of symptoms or the action taken on them. When re-interviewed, after they had refused the test, less than a quarter of the non-acceptors said that their reason for refusal was distaste for faecal sampling.