What are the obstacles and aids to participation in colorectal cancer screening? A qualitative study

  • A. Le Bonniec
  • S. Mas
  • M. Préau
  • F. Cousson-Gélie


Background: Early detected, colorectal cancer can be cured in nine cases out of ten, but it remains the second leading cause of cancer mortality in France (HAS, 2013). In this context, participation in organized screening must be improved. Following the recent change of screening test (change from Hemoccult II to immunological test) it seems important to focus on the changes in the practices of users. Based on the Theory of Social Representations (Jodelet, 1984), this study aims to identify the mains obstacles and facilitators to participation of screening. Methods: Six focus groups were conducted with individuals from the general population (29 volunteer participants, recruited thanks to a French screening structure). A thematic content analysis (Bardin, 1993) and a discourse analysis (IRaMuTeQ software) were performed. Findings: The main obstacles to screening that emerge from the analysis are: the procrastination and the lack of time (necessity to visit the general practitioner), but also the fact that colorectal cancer refers to a part of the body linked to a taboo, and considered dirty. Conversely, the main aids to participation are: the ease of the new test, having an entourage encouraging screening (relatives and general practitioner) and nudging (free test and appointment reminder by mail every two years). During the focus groups, exchanges were fed by the narration of experiences of cancer lived by the participants themselves or by their relatives. Discussion: This study allows a better understanding of adherence to screening and issues about test change through the analysis of social representations.
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