Investigating uptake in faecal immunochemical test (FIT) based colorectal cancer screening

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Date
2017
Authors
Clarke, Nicholas
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University College Cork
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Abstract
Colorectal cancer is a major public health issue, being one of the most diagnosed cancers and one of the leading causes of cancer related mortality. Almost 2500 people are diagnosed with colorectal cancer each year in Ireland and over 1000 die from the disease with males at greater risk. Colorectal cancer is a highly treatable disease if detected at earlier stages. Ireland introduced a National Colorectal Cancer Screening Programme in 2013, using the new faecal immunochemical test (FIT) technology. This was the first time males had been invited to take part in a nationally organised cancer screening programme. This thesis investigates uptake of population-based FIT-based colorectal cancer screening and explores factors associated with uptake in males and females with the intent of providing evidence to improve uptake in screening programmes. The thesis presents an epidemiological study of colorectal cancer in Ireland during 1994 to 2010, prior to national screening. A systematic review shows FIT uptake is low internationally, and significantly lower in males, but importantly that it is not screening programme design influencing differential uptake in males and females. A qualitative study of users and non-users of population-based FIT-based screening shows that a number of factors influence non-uptake in males and females including negative beliefs and emotions related to cancer and screening, poor knowledge and social influences. Additional quantitative analysis of a database of screening invitees shows male gender and increasing deprivation as independently associated with lower uptake. A survey of users and non-users of FIT screening confirms that non-use is influenced by negative beliefs and emotions related to cancer and screening, as well as the influence of a partner or spouse. The thesis has begun to identify factors which may be amenable to the development of interventions to improve uptake in Irelands National Colorectal Cancer Screening Programme.
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Keywords
Uptake , Screening participation , Gender based uptake , Population based screening , Colorectal cancer screening , Faecal immunochemical test , Males
Citation
Clarke, N. 2017. Investigating uptake in faecal immunochemical test (FIT) based colorectal cancer screening. PhD Thesis, University College Cork.