The importance of people's values and preferences for colorectal cancer screening participation.
To explore how individuals reason when they make decisions about participating in colorectal cancer (CRC) screening.



Individuals randomized to FIT or colonoscopy included in the Screening of Swedish Colons (SCREESCO) program was invited to focus group discussions and individual telephone interviews. The concept of shared decision-making (SDM: information; values/preferences; involvement) was used as a matrix for the analyses. To validate findings, additional focus group discussions using the nominal group technique were performed.



Lack of knowledge of CRC and CRC screening was prominent for participants and non-participants, while the results differed between the groups in relation to their values and preferences. The influence of significant others promoted participation while it prevented it among non-participants. Those who participated and those who did not made it clear that there was no need to involve health care professionals when making the decision.



Based on the results, a display of different ways to spread knowledge and communicate about CRC and CRC-screening could be applied such as, community-based information campaigns, decisions aids, interactive questionnaires, chat-functions and telephone support. The disparity in values and preferences between participants and non-participants may be the key to understand why non-participants make their decisions not to participate and warrant further exploration.
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
Kaisa
K
Fritzell
Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.
Kerstin
K
Stake Nilsson
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
Anna
A
Jervaeus
Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Rolf
R
Hultcrantz
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.|Breast and Sarcoma Unit, Radiumhemmet, Karolinska University Hospital, Stockholm, Sweden.
Yvonne
Y
Wengström
D003113:Colonoscopy / Q000523:psychology*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000523:psychology; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D057240:Patient Preference / Q000523:psychology*; D012945:Social Values