title: The prevalence of medical reasons for non-participation in the Scottish breast and bowel cancer screening programmes.
abstract: OBJECTIVE
  Increasing uptake of cancer screening is a priority for health systems internationally, however, some patients may not attend because they are undergoing active treatment for the cancer of interest or have other medical reasons that mean participation would be inappropriate. This study aims to quantify the proportion of non-participants who have a medical reason for not attending cancer screening.
  
  
  METHODS
  Medical reasons for not participating in breast and bowel screening were defined a priori on the basis of a literature review and expert opinion. The notes of 700 patients at two GP practices in Scotland were reviewed, to ascertain the prevalence of medical reasons amongst non-participants. Simple proportions and confidence intervals were calculated.
  
  
  RESULTS
  17.4% of breast and 2.3% of bowel screening non-participants had a medical reason to not participate. The two most common reasons were previous breast cancer follow up (8.86%) and recent mammogram (6.57%).
  
  
  CONCLUSIONS
  These patients may not benefit from screening while also being distressed by receiving an invitation. This issue also makes accurate monitoring and target-setting for improving uptake difficult. Further work is needed to estimate robustly the extent to which medical reasons account for screening non-participation in a larger population.
authors.affiliation: College of Medicine, 47 Little France Crescent, Edinburgh, Midlothian EH16 4TJ s0901736@sms.ed.ac.uk.
authors.forename: L
authors.initials: L
authors.lastname: Mead
authors.affiliation: North Berwick Health Centre, 54 St Baldred's Road, North Berwick, East Lothian EH39 4PU.
authors.forename: L
authors.initials: L
authors.lastname: Porteous
authors.affiliation: South East Scotland Breast Screening Programme, Ardmillan House, Ardmillan Terrace, Edinburgh EH11 2JL.
authors.forename: M
authors.initials: M
authors.lastname: Tait
authors.affiliation: NHS Lothian, Waverley Gate, 2-4 Waterloo Place, Edinburgh, Midlothian EH1 3EG.
authors.forename: R
authors.initials: R
authors.lastname: Stoker
authors.affiliation: Department of Public Health and Health Policy, NHS Lothian, Waverley Gate, 2-4 Waterloo Place, Edinburgh, Midlothian EH1 3EG.
authors.forename: S
authors.initials: S
authors.lastname: Payne
authors.affiliation: Bruntsfield Medical Practice, 11 Forbes Road, Edinburgh EH10 4EY.
authors.forename: C
authors.initials: C
authors.lastname: Calvert
authors.affiliation: Howden Health Centre, Howden road West, Livingston.
authors.forename: D
authors.initials: D
authors.lastname: Maxwell
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Top floor, 200 Renfield Street, Glasgow, G2 3QB.
authors.forename: S V
authors.initials: SV
authors.lastname: Katikireddi
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D008327:Mammography; D008403:Mass Screening / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data*; D015995:Prevalence; D012606:Scotland
keywords: Attendance; Bowel; Breast; Scotland; Screening; non-participation