Investigating factors associated with compliance in the national population-based colorectal cancer screening programme, with particular emphasis on men

Key Information

Researcher: 
Cancer type: 
Colorectal
Research Institution: 
University College Cork
Grant Amount: 
€116,095
Start date: 
September 1, 2012
End date: 
March 31, 2016

Scientific Project Abstract

In Ireland around 2000 people are diagnosed with colorectal cancer (CRC) and 900 die from the disease annually, with more cases and deaths in men than women. CRC rates in Ireland are among the highest in Europe, especially for men. However, CRC can be prevented through screening, and treated effectively, or cured, if caught early. Starting January 2012, CRC screening will be offered to everyone aged 60-69 in Ireland. Those whose screening test is positive need to attend for a hospital procedure (a colonoscopy) which determines whether they have a lesion that needs removed or treated. If the programme is to be successful, uptake needs to be high throughout the programme. Pilot work in Ireland, and evidence from other countries, suggests only half of men and women will participate in screening. Moreover, up to 20% of those who need a colonoscopy will not attend. Evidence also suggests that men are less likely to take part than women. This research aims to understand why men and women in Ireland decide to participate, or not, in CRC screening. Two different approaches (questionnaires and face-to-face interviews) will be used to explore people’s awareness, attitudes, and beliefs about CRC screening. This powerful research methodology will provide an in-depth understanding of the topic. Two groups of people will be included from those invited to take part in FIT (immunochemical testing) screening, and those with a positive screening test who need a colonoscopy. Each group will include participants/attenders and non-participants/non-attenders. People previously invited to take part in screening will be sent a questionnaire through their family doctor. This will include questions about: circumstances, lifestyle, health and health beliefs; preventive health behaviours; knowledge of CRC and screening; whether they think they could get CRC; and whether they took part in screening, what influenced their decision, and, if they didn’t participate, what stopped them. The analysis will compare non-participants with participants and men with women. We will focus on men, since they are likely to have lower compliance. Ten-fifteen men who did not participate in screening and 10-15 men who did not attend colonoscopy will be invited to talk to the researcher about: their decisions; barriers to participation/attendance; and what would have encouraged them to participate/attend. Interviews will be analysed to understand the reasons behind peoples decisions with a particular focus on men due to higher rates of CRC and lower compliance in screening. This research will improve understanding, in Ireland and internationally, of what influences participation in CRC screening, particularly among hard-to-reach groups like men. This will help develop strategies to improve screening participation. Ultimately, it will help ensure the CRC screening programme is a success, and fewer people in Ireland are diagnosed with, and die from, CRC.

For the non-scientist

One-line description: 
Assessing the participation rate of Irish people in colorectal cancer screening, and finding ways to improve it
What this project involves: 

Colorectal cancer rates in Ireland are among the highest in Europe, especially for men. For this reason, a colorectal cancer screening programme is currently being offered to everyone aged 60-69 in Ireland. This project aims to understand why men and women in Ireland decide to participate, or not, in colorectal cancer screening. Questionnaires and face-to-face interviews will be used to explore people's awareness, attitudes, and beliefs about colorectal cancer screening. This study will improve understanding, in Ireland and internationally, of what influences participation in colorectal cancer screening, particularly among hard-to-reach groups like men and will help develop strategies to improve screening participation.