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Study reveals insights into the barriers to bowel cancer screening

University of Southern Queensland investigation has revealed what prevents people from doing the bowel cancer home screening test.
The ‘yuck factor’ of collecting your own stool sample is often said to be the main reason most Australians don’t do the home bowel cancer screening test, but new research suggests people are just as likely to forget or fail to plan for it.

Bowel cancer is Australia’s second deadliest cancer, claiming more than 100 lives every week.

While most cases of bowel cancer can be successfully treated if detected early, almost six in 10 people do not use their free bowel cancer screening test kit when it arrives in the mail.

A joint project between the University of Southern Queensland and Cancer Council Queensland has revealed key insights about what stops people from taking part in the potentially life-saving screening test.

Lead investigator Dr Belinda Goodwin said the study was a promising step towards increasing bowel cancer screening participation.

“We know that many barriers to screening participation exist, but up until now, we were unable to estimate the degree to which each barrier prevented people from completing and returning the test, and who was most likely to experience each barrier,” said Dr Goodwin, an Adjunct Senior Research Fellow at the University of Southern Queensland and a member of the Cancer Council Queensland’s research team.

“This data provides a more reliable way to identify and measure barriers to home bowel cancer screening, which will help design interventions that address poor screening rates in the National Bowel Cancer Screening Program.”

The researchers surveyed more than 400 participants aged 50-74 years. The participants were asked to indicate the degree to which 89 different barriers might prevent them from completing and returning a home bowel cancer test kit.

Of the respondents who didn’t return their most recent kit, the top three barriers were they believed they were up to date with their bowel cancer screening through another method (50.9%), would forget (44.7%) and failed to make plans (37.7%).

Just over one in four respondents indicated embarrassment around storing the sample in their fridge (27.5%), unpleasantness around collecting a stool sample (27.3%) and hygiene concerns (25.2%) acted as barriers to doing the test.

The researchers identified four distinct barrier types: disgust, avoidance, lack of autonomy and physical difficulties. 

They found younger participants were less likely to take part in the test due to disgust, while males who didn’t return their latest kit were more likely to avoid doing it due to a fear of a negative outcome.

“This four-factor measurement tool provides a useful framework to measure and address barriers to home bowel cancer screening going forward,” Dr Goodwin said.

“It could also be used to examine the potential effects of various intervention strategies on different barrier types.”

Dr Goodwin said new initiatives and options to make the kits more user-friendly need to be explored.

“While there are some excellent media campaigns promoting the importance of bowel cancer screening in Australia, our findings suggest intervention strategies that address some of the practical and physical barriers and concerns that limit people’s ability to do the screening must accompany these efforts,” she said.

“This includes encouraging people to make specific plans and prompt them to use their screening kit, and designing easier and cleaner methods for stool collection and storage.”

The article ‘Barriers to home bowel cancer screening’ was published in the journal Psycho-Oncology, and can be read here.

People aged 50-74 can contribute to the next stage of the bowel cancer screening research project by taking part in an online survey.
researcher holding up bowel cancer screening test
Dr Belinda Goodwin.