Reasons for non-participation in the Northern Ireland Bowel Cancer Screening Programme: a qualitative study.
OBJECTIVE
To identify the reasons why some people do not participate in bowel cancer screening so that steps can be taken to improve informed decision-making.


METHODS
Qualitative study, using focus groups with thematic analysis of data to identify, analyse and report patterns. Transcripts were repeatedly read and inductively coded using a phenomenological perspective, and organised into key themes.


METHODS
Belfast and Armagh, two areas of Northern Ireland with relatively low uptake of bowel cancer screening.


METHODS
Ten women and 18 men in three single-gender focus groups (two male and one female), each with 9-10 participants. Study participants were recruited by convenience sampling from the general public and were eligible for, but had not taken part in, the Northern Ireland Bowel Cancer Screening Programme.


RESULTS
Key themes identified were fear of cancer; the test procedure; social norms; past experience of cancer and screening; lack of knowledge or understanding about bowel cancer screening; and resulting behaviour towards the test. Fear about receiving bad news and reluctance to conduct the test themselves were reactions that participants seemed willing to overcome after taking part in open discussion about the test.


CONCLUSIONS
We identified barriers to participation in bowel cancer screening and used these insights to develop new materials to support delivery of the programme. Some of the issues raised have been identified in other UK settings, suggesting that knowledge about barriers, and strategies to improve uptake, may be generalisable.
Public Health Agency, Belfast, UK Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK.
Declan T
http://orcid.org/0000-0003-1468-1823
DT
Bradley
Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK.
Charlene
C
Treanor
Public Health Agency, Belfast, UK.
Colin
C
McMullan
Public Health Agency, Belfast, UK.
Tracy
T
Owen
Public Health Agency, Belfast, UK.
Adele
A
Graham
Public Health Agency, Belfast, UK.
Diane
D
Anderson
D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000523:psychology*; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D009042:Motivation; D009660:Northern Ireland / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010358:Patient Participation / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D012959:Socioeconomic Factors
PUBLIC HEALTH; QUALITATIVE RESEARCH