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Impact of gender on decisions to participate in faecal immunochemical test‐based colorectal cancer screening: a qualitative study
Author(s) -
Clarke Nicholas,
Gallagher Pamela,
Kearney Patricia M.,
McNamara Deirdre,
Sharp Linda
Publication year - 2016
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.4085
Subject(s) - thematic analysis , fatalism , cancer screening , colorectal cancer screening , qualitative research , prostate cancer screening , population , medicine , context (archaeology) , psychology , family medicine , social psychology , cancer , colorectal cancer , prostate cancer , prostate specific antigen , environmental health , sociology , paleontology , social science , philosophy , theology , colonoscopy , biology
Objective Faecal immunochemical tests (FITs) are increasingly being used in population‐based colorectal cancer‐screening programmes. Uptake of FIT is lower in men than women; however, the reasons for this are not well understood. We aimed to explore gender differences in influences on decisions to participate in FIT screening. Methods This is a qualitative study using in‐depth face‐to‐face interviews of four groups of screening invitees (male and female screening users and male and female screening non‐users), purposively sampled from the database of a population‐based FIT screening programme. Recruitment continued until saturation was reached. Interviews were audio recorded and transcribed verbatim. Thematic analysis using the framework approach was employed with the theoretical domains framework guiding analysis. Results Forty‐seven screening invitees were interviewed. Six theoretical domains influenced screening uptake: ‘environmental context and resources’, ‘beliefs about capabilities’, ‘beliefs about consequences’, ‘emotions’, ‘social influences’ and ‘knowledge’. Male non‐users were often fatalistic, less knowledgeable and misinformed about cancer and FIT screening compared with other groups. Female non‐users expressed negative attitudes, beliefs and emotions towards FIT screening, cancer, social influences and the medical profession and were over‐confident about their health. Conclusions Negative attitudes and emotions to screening dominated non‐user decision‐making but differed by gender. Opportunities to improve uptake in men and women exist. Greater national discussions on the benefits of FIT screening, and development of screening materials tackling negative attitudes and beliefs while recognising male/female differences, may improve screening uptake. Copyright © 2016 John Wiley & Sons, Ltd.