Exploring non-participation in colorectal cancer screening: A systematic review of qualitative studies

Worldwide, colorectal cancer is a major public health issue. Despite the existence of screening programmes in many countries, global uptake remains low. This meta-ethnography aimed to analyse qualitative literature to explore attitudes towards colorectal cancer screening and reasons for non-particip...

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Published in:Social science & medicine (1982) 2023-07, Vol.329, p.116022-116022, Article 116022
Main Authors: Le Bonniec, Alice, Meade, Oonagh, Fredrix, Milou, Morrissey, Eimear, O'Carroll, Ronan E., Murphy, Patrick J., Murphy, Andrew W., Mc Sharry, Jenny
Format: Article
Language:eng
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Summary:Worldwide, colorectal cancer is a major public health issue. Despite the existence of screening programmes in many countries, global uptake remains low. This meta-ethnography aimed to analyse qualitative literature to explore attitudes towards colorectal cancer screening and reasons for non-participation in eligible people that do not participate when invited. Systematic searches were conducted in five databases in May 2021. Critical appraisal of included studies was performed using the CASP checklist for qualitative studies. Thirteen studies were included. Three main themes and eight sub-themes were developed across studies: (1) Differences in motivation, with non-participants expressing a lack of knowledge and varying levels of intention to participate but not feeling screening was personally necessary; (2) Active aversion to screening expressed by fear, discomfort, disgust or not wanting to know; and (3) Contextual barriers of the healthcare system such as practical constraints or poor relationships with healthcare professionals. Findings suggest multiple pathways to non-participation including ambivalence, aversion to the process and consequences of screening or lack of support. Persuasive messages and prompts to action to target ambivalence, reassurance regarding the screening procedures to target negative reactions, and increased support from healthcare professionals may be beneficial in increasing screening uptake. •There are multiple pathways to non-participation in colorectal cancer screening.•Non-participants in screening can have varying levels of intention to participate.•Procrastination and postponement can impede participation.•Aversion to screening and contextual barriers are expressed by non-participants.
ISSN:0277-9536
1873-5347