title: Assessing knowledge and attitudes towards screening among users of Faecal Immunochemical Test (FIT).
abstract: BACKGROUND
  Informed decision making is recognized as important in screening. Invitees should be provided with relevant information, enabling them to make an informed decision. This may be more difficult in ethnic minority and low socio-economic status groups. We aimed to assess the proportion of informed decisions to participate in a faecal immunochemical test (FIT)-based colorectal cancer (CRC) screening pilot and to explore differences in knowledge and attitude across various subgroups.
  
  
  METHODS
  Asymptomatic persons aged 50-74 were invited to a second round of a Dutch FIT-based pilot screening programme for CRC. An information leaflet containing all information relevant to enable informed decision making accompanied the invitation. Informed choice was assessed by a mailed questionnaire. Knowledge was elicited through 18 items and attitude towards screening through four items. Main outcome measure was the proportion of informed decision makers among participants. Differences between subgroups were evaluated using logistic regression.
  
  
  RESULTS
  Of 5367 screening participants, 2774 (52%) completed the questionnaire. Knowledge was adequate in 2554 (92%); 2736 (99%) showed a positive attitude towards screening. A total of 2525 persons had made an informed choice (91%); male gender, low education level, non-Dutch ethnicity and not speaking Dutch at home were negatively associated with having adequate knowledge in multivariable analysis.
  
  
  CONCLUSIONS
  In FIT-based screening for CRC, the majority of responders made an informed decision to participate. However, we did not succeed in equally providing all population subgroups with sufficient information. Future initiatives should be aimed at reaching these groups to further enable informed decision making.
authors: Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands.
authors: Maaike J
authors: MJ
authors: Denters
authors: Department of Public Health, Amsterdam, The Netherlands.
authors: Marije
authors: M
authors: Deutekom
authors: Department of Public Health, Amsterdam, The Netherlands.
authors: Marie-Louise
authors: ML
authors: Essink-Bot
authors: Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, the Netherlands.
authors: Patrick M
authors: PM
authors: Bossuyt
authors: Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands.
authors: Paul
authors: P
authors: Fockens
authors: Department of Gastroenterology and Hepatology, Amsterdam, The Netherlands.
authors: Evelien
authors: E
authors: Dekker
mesh_terms: D000368:Aged; D002755:Choice Behavior; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology; D003657:Decision Making; D055088:Early Detection of Cancer / Q000379:methods* / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009780:Occult Blood; D011795:Surveys and Questionnaires
keywords: attitude; colorectal cancer; informed decision making; knowledge; prevention; screening