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Understanding of a negative bowel screening result and potential impact on future symptom appraisal and help-seeking behaviour: a focus group study.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Barnett, Karen N 
Weller, David 
Smith, Steve 
Orbell, Sheina 
Vedsted, Peter 

Abstract

BACKGROUND: Colorectal cancer (CRC) screening using a faecal occult blood test (FOBt) has the potential to reduce cancer-related mortality. Symptom vigilance remains crucial as a proportion of cancers will be diagnosed between screening rounds. A negative FOBt has the potential to influence how participants respond to future symptoms of CRC. OBJECTIVE: To explore (i) understanding of a negative FOBt and (ii) the potential impact of a negative FOBt upon future symptom appraisal and help-seeking behaviour. DESIGN: Qualitative methodology utilizing focus groups with participants who received a negative FOBt within the National Bowel Cancer Screening Programme in Coventry and Lothian. Topics explored included: experience of screening participation, interpretation and understanding of a negative result, symptom awareness and attitudes towards help-seeking. RESULTS: Four broad themes were identified: (i) emotional response to a negative FOBt, (ii) understanding the limitations of FOBt screening, (iii) symptom knowledge and interpretation and (iv) over-reassurance from a negative FOBt. Participants were reassured by a negative FOBt, but there was variability in the extent to which the result was interpreted as an "all clear". Some participants acknowledged the residual risk of cancer and the temporal characteristic of the result, while others were surprised that the result was not a guarantee that they did not have cancer. DISCUSSION AND CONCLUSIONS: Participants recognized that reassurance from a negative FOBt could lead to a short-term delay in help-seeking if symptoms developed. Screening programmes should seek to emphasize the importance of the temporal nature of FOBt results with key messages about symptom recognition and prompt help-seeking behaviour.

Description

This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1111/hex.12484

Keywords

Scotland, bowel cancer, colorectal cancer, colorectal cancer screening, focus groups, guaiac faecal occult blood test, health knowledge, negative screening results, symptom appraisal, Aged, Awareness, Colorectal Neoplasms, Early Detection of Cancer, England, Female, Focus Groups, Help-Seeking Behavior, Humans, Male, Mass Screening, Middle Aged, Occult Blood, Scotland

Journal Title

Health Expect

Conference Name

Journal ISSN

1369-6513
1369-7625

Volume Title

Publisher

Wiley
Sponsorship
This study was funded by the National Awareness and Early Diagnosis Initiative led by Cancer Research UK, the Department of Health, NHS England and Public Health England. Award number C12357/A12240.