TY - JOUR

T1 - Why do some participants in colorectal cancer screening choose not to undergo colonoscopy following a positive test result? A qualitative study

AU - Bie, Anne Katrine Lykke

AU - Brodersen, John

PY - 2018

Y1 - 2018

N2 - Objective: Our aim was to investigate why participants opted out of colonoscopy following a positive screening result for colorectal cancer. Design: Semi-structured, qualitative, single interviews. We audio-recorded and transcribed all interviews verbatim and used Strauss and Corbin’s concept of open, axial, and selective coding to identify the main categories shared across all interviews. These formed the basis of our findings. Setting: A Danish national colorectal cancer screening programme. Subjects: Single interviews with 13 participants who declined to have a colonoscopy. Main outcome measures: Reasons to decline colonoscopy after positive screening test. Results: Participants gave 42 different reasons for deciding not to have a colonoscopy and we coded them into nine main categories; Practical barriers, Discomfort of the examination, Personal integrity, Multimorbidity, Feeling healthy, Not having the energy, Belief that cancer is not present, Risk of complications, and Distrust in the accuracy of the iFOBT. Conclusions: Our findings suggest that some practical barriers could be quite easily addressed, by offering the participants alternative management and procdures. Implications: Further research is needed to examine how widely our findings are represented in the general population, and how general practitioners should consult with patients who have opted out of colonoscopy, despite a positive screening result.Key points   Some screening participants are reluctant to proceed with further diagnostic tests for colorectal cancer following a positive screening result.   • Interviews with people, who had refused a follow-up colonoscopy, discovered nine categories (42 reasons) of reasons for refusal.   • Reluctance can be addressed by offering support with pre-procedure preparations and alternatives to colonoscopy.   • General practitioners face ethical dilemmas and challenges, when patients at risk of colorectal cancer decline to proceed with screening.

AB - Objective: Our aim was to investigate why participants opted out of colonoscopy following a positive screening result for colorectal cancer. Design: Semi-structured, qualitative, single interviews. We audio-recorded and transcribed all interviews verbatim and used Strauss and Corbin’s concept of open, axial, and selective coding to identify the main categories shared across all interviews. These formed the basis of our findings. Setting: A Danish national colorectal cancer screening programme. Subjects: Single interviews with 13 participants who declined to have a colonoscopy. Main outcome measures: Reasons to decline colonoscopy after positive screening test. Results: Participants gave 42 different reasons for deciding not to have a colonoscopy and we coded them into nine main categories; Practical barriers, Discomfort of the examination, Personal integrity, Multimorbidity, Feeling healthy, Not having the energy, Belief that cancer is not present, Risk of complications, and Distrust in the accuracy of the iFOBT. Conclusions: Our findings suggest that some practical barriers could be quite easily addressed, by offering the participants alternative management and procdures. Implications: Further research is needed to examine how widely our findings are represented in the general population, and how general practitioners should consult with patients who have opted out of colonoscopy, despite a positive screening result.Key points   Some screening participants are reluctant to proceed with further diagnostic tests for colorectal cancer following a positive screening result.   • Interviews with people, who had refused a follow-up colonoscopy, discovered nine categories (42 reasons) of reasons for refusal.   • Reluctance can be addressed by offering support with pre-procedure preparations and alternatives to colonoscopy.   • General practitioners face ethical dilemmas and challenges, when patients at risk of colorectal cancer decline to proceed with screening.

KW - cancer screening test

KW - colonoscopy

KW - Colorectal neoplasms

KW - mass screening

KW - qualitative research

U2 - 10.1080/02813432.2018.1487520

DO - 10.1080/02813432.2018.1487520

M3 - Journal article

C2 - 30238859

AN - SCOPUS:85053689122

VL - 36

SP - 262

EP - 271

JO - Scandinavian Journal of Primary Health Care

JF - Scandinavian Journal of Primary Health Care

SN - 0281-3432

IS - 3

ER -