title: Low priority main reason not to participate in a colorectal cancer screening program with a faecal occult blood test.
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.
authors: Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. a.f.vanrijn@amc.uva.nl
authors: A F
authors: AF
authors: van Rijn
authors: L G M
authors: LG
authors: van Rossum
authors: M
authors: M
authors: Deutekom
authors: R J F
authors: RJ
authors: Laheij
authors: P
authors: P
authors: Fockens
authors: P M M
authors: PM
authors: Bossuyt
authors: E
authors: E
authors: Dekker
authors: J B M J
authors: JB
authors: Jansen
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011159:Population Surveillance; D016730:Program Development; D015397:Program Evaluation; D011634:Public Health; D040241:Social Marketing