Pharmacy bowel screens pass the test

Rotary Bowelscan pic

Convenience trumps faecal aversion when it comes to bowel cancer screening, according to a new CSIRO-led study.

While blood-based screening averts the need for faecal testing – which many can find difficult or uncomfortable to conduct – the increased contact with health professionals required to complete blood screening is a barrier to participation, researchers have found.

In the study of 1500 South Australians aged 45 to 74, mostly recruited via social media, respondents indicated a strong initial preference for a blood test (79.6%) compared to a stool test (20.4%).

However when presented with a set of screening scenarios, the likelihood of respondents actually participating in blood-based screening was found to be significantly lower than the current at-home stool sampling approach.

The likelihood of taking a home-based faecal test rated better compared with all four of the blood scenarios, including a home-blood test, and a blood test requiring one, two, or three visits to a health practitioner.

“As screening becomes more time consuming, involving multiple visits to medical practitioners and pathology collection centres, likelihood of screening significantly decreases,” say the authors from CSIRO, the University of Adelaide, and Flinders University, South Australia.

The results demonstrate that consumer decision making is “multifaceted” and not driven purely by overall sample preference, they add.

Men, people aged 55 to 59, and those with prior experience of using an at-home faecal test were also more likely to prefer it over blood testing.

Despite strong evidence of benefit from faecal screening, overall uptake in the National Bowel Cancer Screening Program currently sits at a low ~35%, with participation rates similarly low internationally.

The authors are hoping an increase in the efficiency of screening methods will ensure the overall screening process remains convenient for individuals, and eventually lift participation rates.

ANZJPH 2016; online 15 May

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