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Barriers and facilitators to colonoscopy following fecal immunochemical test screening for colorectal cancer: A key informant interview study

Kerrison, RS; Travis, E; Dobson, C; Whitaker, KL; Rees, CJ; Duffy, SW; von Wagner, C; (2021) Barriers and facilitators to colonoscopy following fecal immunochemical test screening for colorectal cancer: A key informant interview study. Patient Education and Counseling 10.1016/j.pec.2021.09.022. (In press). Green open access

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Abstract

OBJECTIVES: People who are referred for colonoscopy, following an abnormal colorectal cancer (CRC) screening result, are at increased risk of CRC. Despite this, many individuals decline the procedure. The aim of this study was to investigate why. METHODS: As little is currently known about non-attendance at follow-up colonoscopy, and follow-up of abnormal screening results is a nurse-led process, we decided to conduct key informant interviews with Specialist Screening Practitioners ([SSPs] nurses working in the English Bowel Cancer Screening Program). Interviews were conducted online. Transcripts were assessed using inductive and deductive coding techniques. RESULTS: 21 SSPs participated in an interview. Five main types of barriers and facilitators to colonoscopy were described, namely: Sociocultural, Practical, Psychological, Health-related and COVID-related. Key psychological and sociocultural factors included: 'Fear of pain and discomfort associated with the procedure' and 'Lack of support from family and friends'. Key practical, health-related and COVID-related factors included: 'Family and work commitments', 'Existing health conditions as competing priorities' and 'Fear of getting COVID-19 at the hospital'. CONCLUSIONS: A range of barriers and facilitators to follow-up colonoscopy exist. Future studies conducted with patients are needed to further explore barriers to colonoscopy. PRACTICE IMPLICATIONS: Strategies to reduce non-attendance should adopt a multifaceted approach.

Type: Article
Title: Barriers and facilitators to colonoscopy following fecal immunochemical test screening for colorectal cancer: A key informant interview study
Location: Ireland
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.pec.2021.09.022
Publisher version: https://doi.org/10.1016/j.pec.2021.09.022
Language: English
Additional information: © 2021 The Author(s). Published by Elsevier B.V. CC_BY_4.0
Keywords: Colonoscopy, Early diagnosis, Fecal immunochemical test, Interviews, Qualitative research, Screening
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10137671
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