Why do I choose to get screened? An examination of factors influencing participation in the Scottish Bowel Screening Programme


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Kirsty Bisset1,Paul G Horgan1,Emilia M Crighton2,David Mansouri1
1Academic Unit of Surgery, School of Medicine - University of Glasgow,2Department of Public Health Screening Unit, NHS Greater Glasgow & Clyde



Uptake of screening for colorectal cancer using the faecal occult blood test is influenced by demographics such as age, sex and socioeconomic deprivation. In addition, an individuals health beliefs and behavioural factors may be of importance. The aim of the present study was to further examine the health beliefs of individuals participating in the Scottish Bowel Screening Programme (SBoSP).


A prospective study of all patients undergoing a colonoscopy following a positive bowel screening test via the SBoSP in our geographical area was carried out. Ultimate (demographics), proximal (health beliefs and social support) and distal (background) factors that could potentially influence participation behaviour were examined using a previously validated questionnaire.


Of the 96 individuals invited, 94(98%) participated. There were 45(48%) males, 50(53%) under the age of 65 and 55(57%) patients were in the two most deprived quintiles of deprivation. Examining proximal variables, participants reported low perceived susceptibility to bowel cancer (mean score 9/20), and high levels of response-efficacy (mean score 8/10), self-efficacy (mean score 20/24) and social support (mean score 3/4). Examining distal variables, a low fear of bowel cancer (mean score 13/32) and high levels of general self-efficacy (mean score 19/25) were noted. There were no significant differences in proximal factors according to age, sex or deprivation status, however there was weak trend for females (mean score 12 vs 14, p=0.055) and the more deprived (mean score 14 vs 12, p=0.097) to have a higher fear of bowel cancer.


High levels of social support, response-efficacy and self-efficacy are present in screening participants across all demographics. Promotion of response-efficacy, which is an individual's perception of the efficacy of the screening programme and treatment, in particular, may represent a potential modifiable target to improve uptake. Further work examining these factors in non-participants is required.