Initial reaction to the invitation for bowel screening

People invited to take part in screening for bowel cancer receive a letter explaining the reason for the invitation and an accompanying leaflet. The leaflet describes the benefits and disadvantages of screening, and notes that screening may not be appropriate for everybody. People can call the programme Freephone helpline on 0800 707 60 60 if they have any questions or if they do not wish to be screened. They can also call this number if aged 74 or over and wish to be screened.

The people we talked to described how they had felt when they had received the letter and leaflet. Many did not relish the prospect of collecting the sample, but negative reactions were often transient if they reasoned that other people were doing the same thing (“Yes, it’s unpleasant and distasteful but it’s part of life,”), and that the test might save lives. Some were pleased to be included in the programme, especially if they were aware of bowel cancer or other bowel problems in the family. A woman who discussed her invitation with her husband who had had bowel cancer said that he told her, “There’s not even any question. You just, you must do it.”

She was pleased to have been invited to be screened.

Age at interview 74

Gender Female

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One woman had had bowel cancer herself in 1990. This had been successfully treated, but she was glad to be screened because she wanted reassurance that she was still free of the disease.

Screening reassured her because she had had bowel cancer long ago.

Age at interview 72

Gender Female

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One man thought it obvious that he should take part.

Says that screening might prevent disease and save life.

Age at interview 59

Gender Male

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Some people were not surprised to be invited to be screened for bowel cancer because they had read about the programme in the local paper or heard about it at their doctor’s surgery.

When he received the invitation he wasn’t surprised because he had read about the programme.

Age at interview 67

Gender Male

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Others reacted rather differently to the invitation. Women are used to screening for various conditions but the UK has no other screening programmes for men. Women tended to see the bowel screening programme as ‘just another check-up’, but the invitation surprised some men.

She thought the invitation to be screened was ‘just another check-up.

Age at interview 70

Gender Female

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The letter of invitation shocked him because he was not used to preventive health care.

Age at interview 65

Gender Male

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A woman in the initial pilot programme was impressed by the scheme, but felt a bit embarrassed about taking part. She also wondered why she in particular had been invited to be screened for bowel cancer. The letter and leaflet she received stated that all those in her age group were being invited for screening but she thought that perhaps her local doctor had also been involved in the selection process.

She was impressed by the screening programme but felt a bit embarrassed about taking part.

Age at interview 57

Gender Female

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Wondered why she had been ‘selected for screening.

Age at interview 57

Gender Female

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People who have no family history or particular concerns about cancer sometimes feel they are not at risk of developing bowel cancer and that the screening programme is not relevant to them. A man who took part in the pilot programme also said that he felt a little bit sceptical about it all. Although through screening he found that he had bowel cancer, he had felt healthy when the letter arrived, ate well and didn’t see a need to be screened. Looking back he thought that his was a typical male attitude to preventive health care.

At first he was sceptical about screening for bowel cancer.

Age at interview 67

Gender Male

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The man mentioned above [Interview 01] who was initially sceptical about the screening programme also had a very negative reaction when asked to repeat the test. He thought that the people involved in screening were just trying to prolong their work and justify their jobs.

He was still sceptical about screening when he was asked to repeat the test.

Age at interview 67

Gender Male

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Others thought that the idea of screening for bowel cancer was “horrible” or “disgusting”. Some were apprehensive, fearing it would be a “messy” procedure, or difficult to do.

She ignored the invitation at first because she thought the whole idea disgusting.

Age at interview 58

Gender Female

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One woman also felt anxious for various reasons, but mainly because she had rheumatoid arthritis in her wrists and thought it would be hard to collect the stool samples needed for bowel screening.

At first she was anxious because she had arthritis. She also thought that screening might be…

Age at interview 70

Gender Female

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Some people had decided not to take part in bowel screening at all. They had various reasons (see Why some were reluctant or did not to take part). This woman binned her letter of invitation.

When she read about possible investigations she put the letter in the waste paper bin.

Age at interview 67

Gender Female

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