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Barriers and facilitators to colonoscopy following faecal immunochemical test screening for colorectal cancer: a key informant interview study

Lookup NU author(s): Dr Christina Dobson, Professor Colin Rees



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


ObjectivesPeople who are referred for colonoscopy, following an abnormal colorectal cancer (CRC) screening result, are at increased risk of CRC. Despite this, many individuals decline the procedure. The aim of this study was to investigate why.MethodsAs little is currently known about non-attendance at follow-up colonoscopy, and follow-up of abnormal screening results is a nurse-led process, we decided to conduct key informant interviews with Specialist Screening Practitioners ([SSPs] nurses working in the English Bowel Cancer Screening Program). Interviews were conducted online. Transcripts were assessed using inductive and deductive coding techniques.Results21 SSPs participated in an interview. Five main types of barriers and facilitators to colonoscopy were described, namely: Sociocultural, Practical, Psychological, Health-related and COVID-related. Key psychological and sociocultural factors included: ‘Fear of pain and discomfort associated with the procedure’ and ‘Lack of support from family and friends’. Key practical, health-related and COVID-related factors included: ‘Family and work commitments’, ‘Existing health conditions as competing priorities’ and ‘Fear of getting COVID-19 at the hospital'.ConclusionsA range of barriers and facilitators to follow-up colonoscopy exist. Future studies conducted with patients are needed to further explore barriers to colonoscopy.Practice implicationsStrategies to reduce non-attendance should adopt a multifaceted approach.

Publication metadata

Author(s): Kerrison R, Travis E, Dobson C, Whitaker K, Rees C, Duffy S, von Wagner C

Publication type: Article

Publication status: Published

Journal: Patient Education and Counselling

Year: 2022

Volume: 105

Issue: 6

Pages: 1652-1662

Print publication date: 01/06/2022

Online publication date: 17/09/2021

Acceptance date: 14/09/2021

Date deposited: 05/10/2021

ISSN (electronic): 0738-3991

Publisher: Elseiver


DOI: 10.1016/j.pec.2021.09.022


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Funder referenceFunder name
Cancer Research UK