Bowel Screening

Why people decide to take part in screening

When people are invited for bowel cancer screening in the UK they are given an information leaflet and encouraged to weigh up the benefits and disadvantages of screening. People's actions are influenced by their perception of the benefits and drawbacks to screening and how much they feel threatened by cancer (also see Why some were reluctant or did not take part).

Most people had decided to take part in screening. One of the strongest motivations was having a close family member who had had bowel cancer. However, it is important to note that anyone can get bowel cancer, though the risk is greater for people with a family history of it. Age is the most important risk factor and people aged 60 and over are at greater risk.

People whose families have been affected by other cancers often also feel more vulnerable to any type of cancer, even though there may be no known connection. 

Those without a personal family history of bowel cancer often described multiple reasons for being screened. A woman whose husband had had bowel cancer took part in screening; she was also influenced by friends who had been diagnosed as the result of screening. Others were aware of screening for breast and cervical cancer and were convinced that “prevention is better than cure”.

People who had had their own brush with cancer often think that screening is a good idea. One woman wanted to take part in screening because she had previously had bowel cancer herself (also see Initial reaction to the invitation for screening), and a man who accepted screening believed that all screening is useful because he thought that his prostate cancer should have been diagnosed sooner. He and others thought that “prevention was better than cure” and applauded the NHS for its screening programme.

People sometimes said that they felt an obligation to be screened if it were offered. A woman who had worked as a secretary with a cancer support group 'knew the importance of early detection'. Another woman, mentioned above [Interview 19], thought that it was “good citizenship” to accept screening when it was offered. She was sure that screening would prevent serious disease and so save money for the NHS. This woman also felt that to some extent her decisions were guided by God. However, another woman didn't feel she had a “duty” to take part in screening. 

The information leaflets also contributed to some people's decisions (also see 'People's views of the initial information leaflet'). People differ in the weight they attach to the short-term and long-term consequences of their actions, so the way in which information is presented may affect whether or not they take part in screening. In the initial pilot scheme people were told that their GP had provided contact details (GPs no longer do this but they are notified when the invitations for bowel screening are being sent out in their area). Some people felt reassured that their GP had been involved in the screening process. 

Others were keen to take part because they had occasionally seen blood in their stools or experienced other bowel problems, such as diverticulitis, haemorrhoids or irritable bowel. 

More than one man said that his wife had insisted that he should take part in screening. A man said that he had encouraged his daughter to see a doctor when she found a breast lump and it would have been inconsistent if he had not accepted screening himself. Another said that although the information had influenced his decision he had the confidence to take part in screening because he felt encouraged and supported by his wife and son, both doctors.

One man took part in screening mainly because he felt fit enough to cope with cancer if it were diagnosed. He thought that it was important to screen for disease at his age because later he might not be able to “fight it off”. 

Last reviewed May 2016.

Last updated May 2016.

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