title: Impact of gender on decisions to participate in faecal immunochemical test-based colorectal cancer screening: a qualitative study.
abstract: Faecal immunochemical tests (FITs) are increasingly being used in population-based colorectal cancer-screening programmes. Uptake of FIT is lower in men than women; however, the reasons for this are not well understood. We aimed to explore gender differences in influences on decisions to participate in FIT screening.
  
  
  
  This is a qualitative study using in-depth face-to-face interviews of four groups of screening invitees (male and female screening users and male and female screening non-users), purposively sampled from the database of a population-based FIT screening programme. Recruitment continued until saturation was reached. Interviews were audio recorded and transcribed verbatim. Thematic analysis using the framework approach was employed with the theoretical domains framework guiding analysis.
  
  
  
  Forty-seven screening invitees were interviewed. Six theoretical domains influenced screening uptake: 'environmental context and resources', 'beliefs about capabilities', 'beliefs about consequences', 'emotions', 'social influences' and 'knowledge'. Male non-users were often fatalistic, less knowledgeable and misinformed about cancer and FIT screening compared with other groups. Female non-users expressed negative attitudes, beliefs and emotions towards FIT screening, cancer, social influences and the medical profession and were over-confident about their health.
  
  
  
  Negative attitudes and emotions to screening dominated non-user decision-making but differed by gender. Opportunities to improve uptake in men and women exist. Greater national discussions on the benefits of FIT screening, and development of screening materials tackling negative attitudes and beliefs while recognising male/female differences, may improve screening uptake. Copyright © 2016 John Wiley & Sons, Ltd.
authors: National Cancer Registry Ireland, Cork, Ireland.|Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
authors: Nicholas
authors: 0000-0001-8666-5449
authors: N
authors: Clarke
authors: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland.
authors: Pamela
authors: P
authors: Gallagher
authors: Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
authors: Patricia M
authors: PM
authors: Kearney
authors: Department of Clinical Medicine, Trinity Centre for Health Sciences, Adelaide and Meath Hospital, Dublin, Ireland.
authors: Deirdre
authors: D
authors: McNamara
authors: National Cancer Registry Ireland, Cork, Ireland.|Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.
authors: Linda
authors: L
authors: Sharp
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000523:psychology*; D003657:Decision Making; D055088:Early Detection of Cancer / Q000523:psychology*; D004644:Emotions; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology; D036301:Qualitative Research; D012737:Sex Factors