Psychosocial and sociodemographic factors influencing colorectal cancer screening uptake: a qualitative analysis
AbstractBackground: Colorectal cancer (CRC) is a leading cause of mortality and morbidity. Regular screening is linked to significant reductions in CRC incidence and mortality, however uptake remains low. We explored factors influencing decision-making in relation to CRC screening by variation in ethnicity, socioeconomic status (SES), gender and screening history. Methods: Semi-structured interviews were undertaken with 27 people aged 60-74 years. Men (n=12) and women (n=15), who had previously been screened (n=15) or not (n=12), took part. Participants were from White British (n=13) and ethnic minority backgrounds (n=14), and had either low (n=11) or high SES (n=16). SES was assessed based on postcodes using the Index of Multiple Deprivation. Interviews were analysed using Thematic Analysis. Findings: Main themes were Perceived Barriers, Perceived Benefits and Improving Uptake. Non-screeners were more negative towards screening, more likely to perceive cancer as a ‘taboo’ and expressed less positive views towards treatment options. Men were less positive towards the screening process and experienced more aversive emotions (e.g. embarrassment, disgust) than women. Cancer fear was a barrier for all ethnic groups of varying SES. Valuing early diagnosis and a sense of obligation towards the health system facilitated screening for female, White British participants. Difficulty to understand health information was a barrier for low SES and ethnic minority participants. Discussion: Structural barriers, such as the difficulty to process health-related information, as well as emotional barriers, such as fear and disgust, may contribute to explaining low CRC screening uptake. Consideration of particular groups could be useful for intervention development.
Copyright (c) 2017 A. Tsipa, D. O'Connor, M. Conner, F. Day
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