Repeat adherence to colorectal cancer screening utilising faecal occult blood testing : a community-based approach in a rural setting

Hughes, Karen Leigh (2006) Repeat adherence to colorectal cancer screening utilising faecal occult blood testing : a community-based approach in a rural setting. Masters by Research thesis, Queensland University of Technology.


In Australia, colorectal cancer (CRC) is the most common registrable cancer affecting both men and women, and the third most common cause of cancer deaths. Clinical data from randomised, controlled trials indicate that population-based screening utilising the faecal occult blood test (FOBT) can reduce mortality from this disease. However, high adherence rates with repeated testing are required to secure these outcomes. This study examines repeat adherence with FOBT screening in a rural community two years after a first screening round was conducted. Patients, aged 50 to 74 years, registered with four local general practices were mailed a FOBT kit with a letter of invitation from their general practitioner. Following the intervention, 119 telephone interviews were conducted with adherers and non-adherers to examine knowledge and attitudes related to screening. Compliance with screening was recorded and compared with first round-data. Participation in the screening program was modest. Of the 3,406 participants eligible for both screening rounds, 34.1% and 34.7% participated in rounds 1 and 2, respectively. A majority of participants (56.8%) did not adhere to either screening, a quarter (25.7%) participated in both rounds, and 17.5% participated in one of the two rounds. First-round adherence was the strongest predictor of second-round adherence (OR=16.29; 95% CI: 13.58, 19.53) with 75.2% of first-round adherers completing a FOBT in round 2. Females were also more likely to adhere in both rounds, although the difference between females and males decreased across rounds. Knowledge and attitudes differed between adherers and non-adherers and are discussed within the context of the major findings. Results from this trial indicate that achieving high levels of compliance in a national screening program will be challenging. Strategies to increase repeat adherence are suggested.

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ID Code: 16416
Item Type: QUT Thesis (Masters by Research)
Supervisor: Newman, Beth
Keywords: colorectal cancer, mass screening, faecal occult blood test, patient participation, patient compliance, secondary prevention, public health
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Schools > School of Public Health & Social Work
Department: Faculty of Health
Institution: Queensland University of Technology
Copyright Owner: Copyright Karen Leigh Hughes
Deposited On: 03 Dec 2008 04:03
Last Modified: 01 Jun 2016 06:55

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