Patient attitudes towards changes in colorectal cancer surveillance: An application of the Health Belief Model.

2022-09-24

Dix, Maddison

Wilson, Carlene J

Flight, Ingrid H

Wassie, Molla M

Young, Graeme P

Cock, Charles

Cohen-Woods, Sarah

Symonds, Erin L

colonoscopy

colorectal neoplasms

early detection of cancer

faecal occult blood test

patient preference

population surveillance

Journal Article

https://orcid.org/0000-0002-9934-8079

https://orcid.org/0000-0002-1883-4690

https://orcid.org/0000-0001-7704-0869

https://orcid.org/0000-0002-3565-2397

https://orcid.org/0000-0001-9458-8383

https://orcid.org/0000-0003-3578-1137

https://orcid.org/0000-0003-2199-6129

https://orcid.org/0000-0003-2451-0358

10.1111/ecc.13713

This is to determine whether health beliefs regarding colorectal cancer (CRC) screening could predict discomfort with a change to CRC surveillance proposing regular faecal immunochemical tests (FIT) instead of colonoscopy. Eight hundred individuals enrolled in a South Australian colonoscopy surveillance programme were invited to complete a survey on surveillance preferences. Responses were analysed using binary logistic regression predicting discomfort with a hypothetical FIT-based surveillance change. Predictor variables included constructs based on the Health Belief Model: perceived threat of CRC, perceived confidence to complete FIT and colonoscopy (self-efficacy), perceived benefits from current surveillance and perceived barriers to FIT and colonoscopy. A total of 408 participants (51%) returned the survey (complete data n = 303; mean age 62 years, 52% male). Most participants (72%) were uncomfortable with FIT-based surveillance reducing colonoscopy frequency. This attitude was predicted by a higher perceived threat of CRC (OR = 1.03 [95% CI 1.01-1.04]), higher colonoscopy self-efficacy (OR = 1.34 [95% CI 1.13-1.59]) and lower perceived barriers to colonoscopy (OR = 0.92 [95% CI 0.86-0.99]). Health beliefs regarding colonoscopy and perceived threat of CRC may be important to consider when changing CRC surveillance protocols. If guideline changes were introduced, these factors should be addressed to provide patients reassurance concerning the efficacy of the alternative protocol.

link

European Journal of Cancer Care 2022; 31(6)

European Journal of Cancer Care