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Journal of Public Health Advance Access originally published online on August 20, 2008
Journal of Public Health 2008 30(4):461-465; doi:10.1093/pubmed/fdn063
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© The Author 2008, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Low priority main reason not to participate in a colorectal cancer screening program with a faecal occult blood test



A. F. van Rijn
, Research PhD Fellow1

L. G. M. van Rossum
, Research PhD Fellow2

M. Deutekom
, Senior Research Fellow, Epidemiologist3

R. J. F. Laheij
, Senior Research Fellow, Epidemiologist2

P. Fockens
, Professor of Endoscopy1

P. M. M. Bossuyt
, Professor of Biostatistics and Epidemiology4

E. Dekker
, Senior Research Fellow, Gastroenterologist1

J. B. M. J. Jansen
, Professor of Gastroenterology2
1 Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, C2-231, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
2 Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Centre, The Netherlands
3 Department of Social Medicine, Academic Medical Centre, University of Amsterdam, The Netherlands
4 Department of Biostatistics and Epidemiology, Academic Medical Centre, University of Amsterdam, The Netherlands


Address correspondence to A. F. van Rijn, E-mail: a.f.vanrijn{at}amc.uva.nl


   Abstract

Background Compared with screening programs for breast and cervical cancer, reported participation rates for colorectal cancer (CRC) screening are low. The effectiveness of a screening program is strongly influenced by the participation rate. The aim of this study was to investigate the main reasons not to participate in a population-based, invitational CRC screening program.

Methods In the Dutch study program for CRC screening, a random selection of 20 623 persons were invited received a faecal occult blood test. Of the non-participants, 500 were randomly selected and contacted for a standardized telephone interview from November 2006 to May 2007 to document the main reason not to participate.

Results In total, 312 (62%) non-participants could be included for analysis. Most frequently, reported reasons for non-participation were time-related or priority-related (36%), including ‘did not notice test in mailbox’ (13%) and ‘forgot’ (8%). Other reasons were health-related issues, such as ‘severe illness’ (9%), or emotional reasons, such as ‘family circumstances’ (7%).

Conclusions The majority of the reported reasons not to participate reflect low priority for screening. Adding extra instructions and information, and addressing specific concerns through additional interventions should be considered to improve individual decision-making about participation in future CRC population-based screening programs.

Keywords: Screening, cancer


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