title: Predictors of re-participation in faecal occult blood test- based screening for colorectal cancer.
abstract: BACKGROUND
  There is little information on longitudinal patterns of participation in faecal occult blood test (FOBT) based colorectal cancer (CRC) screening or on demographic or behavioural factors associated with participation in re-screening. The lack of an agreed system for describing participatory behaviour over multiple rounds also hampers our ability to report, understand and make use of observed associations. Our aims were to develop a system for describing patterns of participatory behaviour in FOBT-based CRC screening programs and to identify factors associated with particular behavioural patterns.
  
  
  METHODS
  A descriptive framework was developed and applied to a data extract of screening invitation outcomes over two rounds of the NBCSP. The proportion of invitees in each behaviour category was determined and associations between behaviour patterns and demographic and program factors were identified using multivariate analyses.
  
  
  RESULTS
  We considered Re- Participants, Dropouts, Late Entrants and Never Participants to be the most appropriate labels for the four possible observed participatory categories after two invitation rounds. The screening participation rate of the South Australian cohort of the NBCSP remained stable over two rounds at 51%, with second round Dropouts (10.3%) being balanced by Late Entrants (10.5%). Non-Participants comprised 38.7% of invitees. Relative to Re-Participants, Dropouts were older, more likely to be female, of lower SES, had changed their place of residence between offers had a positive test result in the first round. Late Entrants tended to be in the youngest age band.
  
  
  CONCLUSIONS
  Specific demographic characteristics are associated with behavioural sub-groups defined by responses to 2 offers of CRC screening. Targeted group-specific strategies could reduce dropout behaviour or encourage those who declined the first invitation to participate in the second round. It will be important to keep first round participants engaged in order to maximise the benefit of a CRC screening program.
authors: Flinders Centre for Innovation in Cancer, Australia. Steve.cole@health.sa.gov.au
authors: Stephen R
authors: SR
authors: Cole
authors: Tess
authors: T
authors: Gregory
authors: Alex
authors: A
authors: Whibley
authors: Paul
authors: P
authors: Ward
authors: Deborah
authors: D
authors: Turnbull
authors: Carlene
authors: C
authors: Wilson
authors: Ingrid
authors: I
authors: Flight
authors: Adrian
authors: A
authors: Esterman
authors: Graeme P
authors: GP
authors: Young
mesh_terms: D001315:Australia; D015179:Colorectal Neoplasms / Q000175:diagnosis; D055088:Early Detection of Cancer; D006801:Humans; D008403:Mass Screening; D015999:Multivariate Analysis; D009780:Occult Blood