Factors affecting uptake of bowel screening


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Patricia Gunning1, Frank Dunstan1, Ronan Lyons2, Rosemary Fox3
1Cardiff University, Cardiff, UK, 2Swansea University, Swansea, UK, 3Public Health Wales, Cardiff, UK

Background

Uptake of bowel screening has been lower than hoped in Wales. We aimed to characterise eligible individuals invited for screening who are at high risk of developing bowel cancer and who do not take up screening, and to try to identify opportunities for encouraging them to be screened through routine contact with health professionals.

Method

Data for the first year of the Bowel Screening Wales programme were linked to breast and cervical screening data, in-patient and out-patient data and GP records held in the Secure Anonymised Information Linkage system in Swansea University. Responders and non-responders were compared for 12 months either side of the screening invitation with respect to demographic, geographical and clinical characteristics. High risk groups of diabetic and obese subjects, identified through Read codes in GP records, were examined as well as those who took up the offer of the influenza vaccination and who shared a residence with another invitee.

Results

The overall uptake was 54.5% in 170,085 subjects invited for screening. Uptake was much higher (61.4%) in those aged 65 to 69 who had an influenza vaccination than in those who did not (44.1%). Uptake was slightly higher (58.8%) in subjects who shared a residence with another invitee than in those who did not (53.4%). Subjects with diabetes were less likely to be screened (52.1%) compared to those without diabetes (55.7%). Subjects who were obese were less likely to be screened (52.9%) than non-obese subjects (55.2%). This was more marked in women than men.

Conclusion

This early work has identified a number of differences between responders and non-responders. Results show potential to encourage screening among subjects with diabetes. Future work will examine health service contacts in more detail and identify strategies for targeting subjects to increase bowel screening uptake.