title: "It's a small price to pay for life": faecal occult blood test (FOBT) screening for colorectal cancer, perceived barriers and facilitators.
abstract: OBJECTIVE
  To clarify perceptions influencing FOBT screening participation among the NZ European target population.
  
  
  METHODS
  Participants (30 female, 20 male; 50-71 years) recruited through urban (Auckland, Wellington, Christchurch) GP surgeries for in-depth, face-to-face interviews (digitally recorded and professionally transcribed verbatim). A pragmatic approach focused on aggregating transcript content.
  
  
  RESULTS
  Participants believed early CRC lacked distinguishing signs and symptoms, but was treatable and suitable for screening, although slow development may undermine any sense of urgency. FOBT inaccuracies caused concern, particularly false negatives, but ongoing testing could reduce anxiety. Specimen collection was awkward, challenged social norms and individual squeamishness, but provided peace of mind, was painless, simple and private without high cost technological or professional involvement. Lacking preventive attitudes and experience of health responsibilities and screening, men were less likely to participate than women. CRC lacked public profile, highlighting government responsibility, before programme implementation, to resource high-profile education, largely through TV. General practitioner support and promotion was seen as critical. Inadequate health system capacity and resourcing was problematic.
  
  
  CONCLUSIONS
  Despite challenging barriers, participants identified opportunities to increase FOBT screening participation, especially promotion to raise CRC profile, overcome perceived normative barriers and build self-efficacy. Adequate resourcing is essential to support appropriate promotion and timely programme delivery.
authors: Cancer Society of New Zealand Social and Behavioural Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand. tony.reeder@otago.ac.nz
authors: Anthony I
authors: AI
authors: Reeder
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009520:New Zealand / Q000453:epidemiology; D009780:Occult Blood; D011379:Prognosis; D011634:Public Health / Q000639:trends*; D015996:Survival Rate / Q000639:trends