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Health Expect. 2018 Aug;21(4):764-773. doi: 10.1111/hex.12672. Epub 2018 Feb 19.

The contribution of a negative colorectal screening test result to symptom appraisal and help-seeking behaviour among patients subsequently diagnosed with an interval colorectal cancer.

Author information

1
University of Edinburgh, Edinburgh, UK.
2
Midlands and NW Bowel Cancer Screening Programme Hub, Rugby, UK.
3
University of Dundee, Dundee, UK.
4
Aarhus University, Aarhus, Denmark.
5
University of Essex, Colchester, UK.
6
Queen Mary University of London, London, UK.
7
University of Cambridge, Cambridge, UK.
8
University of Oxford, Oxford, UK.

Abstract

BACKGROUND:

Colorectal cancer (CRC) screening programmes using a guaiac faecal occult blood test (gFOBt) reduce CRC mortality. Interval cancers are diagnosed between screening rounds: reassurance from a negative gFOBt has the potential to influence the pathway to diagnosis of an interval colorectal cancer.

METHODS:

Twenty-six semi-structured face-to-face interviews were carried out in Scotland and England, with individuals diagnosed with an interval colorectal cancer following a negative gFOBt result.

RESULTS:

Participants reported they were reassured by a negative gFOBt, interpreting their result as an "all clear". Therefore, most did not suspect cancer as a possible cause of symptoms and many did not recall their screening result during symptom appraisal. Among those who did consider cancer, and did think about their screening test result, reassurance from a negative gFOBt led some to "downplay" the seriousness of their symptoms with some interviewees explicitly stating that their negative test result contributed to a delayed decision to seek help.

CONCLUSION:

Screening participants need to be informed of the limitations of screening and the ongoing risk of developing colorectal cancer even when in receipt of a negative result: the importance of minimizing delay in seeking medical advice for colorectal symptoms should be emphasized.

KEYWORDS:

colorectal cancer screening; help-seeking; interval cancer; negative screening result; symptom appraisal; understanding of screening

PMID:
29457677
PMCID:
PMC6117494
DOI:
10.1111/hex.12672
[Indexed for MEDLINE]
Free PMC Article

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