Motives for non-adherence to colonoscopy advice after a positive colorectal cancer screening test result: a qualitative study

Bertels, Lucinda; Asselt, Kristel van; Dekker, Evelien; Weert, Henk van; Knottnerus, Bart

doi:10.1080/02813432.2020.1844391

Cited by 12 publications

(24 citation statements)

References 48 publications

(66 reference statements)

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“…Moreover, in this study, we did not include FIT‐positive individuals who did not undergo colonoscopy; however, these were included in two other studies reporting on this research project. 20 , 39 Lastly, the majority of participants in both the interviews and the questionnaire were born in the Netherlands, which limits conclusions to individuals with a similar background and does not account for potential cultural differences in decision‐making.…”

Section: Discussionmentioning

confidence: 99%

“…This was part of an investigation on reasons for (non‐)follow‐up in CRC screening, as reported elsewhere. 20 Participants in the CRC screening programme were recruited in GP practices, by an online newsletter from a national elderly organisation (ANBO) and on social media (Facebook). Inclusion criteria were a positive FIT in the past 12 months followed by colonoscopy within 6 months hereafter.…”

Section: Methodsmentioning

confidence: 99%

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Decision‐making in screening positive participants who follow up with colonoscopy in the Dutch colorectal cancer screening programme: A mixed‐method study

et al. 2021

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Objective: To explore worry and decision-making processes used by faecal immunochemical test (FIT)-positive participants in the Dutch national screening programme for colorectal cancer. Methods:A mixed-methods study consisting of 22 semi-structured interviews in FIT-positive participants who underwent the recommended colonoscopy within 4-6 months after the FIT result, followed by a widespread questionnaire in a larger target population (N = 1495). Results:In the interviews, we recognised two different decision-making processes.The first is an affective heuristic decision process where the decision to participate is made instantly and is paired with high-risk perception, worry and (severe) emotional turmoil. The second is a more time-consuming analytical decision process in which participants describe discussing options with others. In the questionnaire, high levels of cancer worry (CWS > 9) were reported by 34% of respondents.Decisional difficulties were reported by 15% of respondents, and 34% of respondents reported discussing the positive FIT result with their GP. Individuals with high levels of cancer worry contacted their GP less often than those with low levels. Conclusions:The Dutch two-step screening programme may result in high levels of cancer worry in a non-cancer population. More research is needed to monitor worry and its role in decision-making in cancer screening, as well as ways to facilitate decision-making for participants.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Decision‐making in screening positive participants who follow up with colonoscopy in the Dutch colorectal cancer screening programme: A mixed‐method study

et al. 2021

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“…Two of the 4 reasons highlighted by the Canadian study—patients' fear of colonoscopy and breakdown in communication of abnormal FOBT results or colonoscopy appointments—were also identified in our study. Another qualitative study involved 17 patients who did not undergo colonoscopy after a positive FIT result in the Dutch national screening program, which notifies individuals of their positive FIT result along with a premade appointment for colonoscopy consultation within 2 weeks ( 30 ). The Dutch program had a follow-up colonoscopy rate of greater than 85%.…”

Section: Discussionmentioning

confidence: 99%

Timely Colonoscopy After Positive Fecal Immunochemical Tests in the Veterans Health Administration: A Qualitative Assessment of Current Practice and Perceived Barriers

Mog

Liang

Donovan

et al. 2022

Clin Transl Gastroenterol

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INTRODUCTION: The Veterans Health Administration introduced a clinical reminder system in 2018 to help address process gaps in colorectal cancer screening, including the diagnostic evaluation of positive fecal immunochemical test (FIT) results. We conducted a qualitative study to explore the differences between facilities who performed in the top vs bottom decile for follow-up colonoscopy. METHODS:Seventeen semistructured interviews with gastroenterology (GI) providers and staff were conducted at 9 high-performing and 8 low-performing sites. RESULTS:We identified 2 domains, current practices and perceived barriers, and most findings were described by both high-and low-performing sites. Findings exclusive to 1 group mainly pertained to current practices, especially arranging colonoscopy for FIT-positive patients. We observed only 1 difference in the perceived barriers domain, which pertained to primary care providers.DISCUSSION:These results suggest that what primarily distinguishes high-and low-performing sites is not a difference in barriers but rather in the GI clinical care process. Developing and disseminating patient education materials about the importance of diagnostic colonoscopy, eliminating in-person precolonoscopy visits when clinically appropriate, and involving GI in missed colonoscopy appointments and outside referrals should all be considered to increase follow-up colonoscopy rates.Our study illustrates the challenges of performing a timely colonoscopy after a positive FIT result and provides insights on improving the clinical care process for patients who are at substantially increased risk for colorectal cancer.

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“…This is in addition to studies that have found finances and the provider-patient relationship were associated with nonadherence. [18][19][20] Respondents noted that healthcare providers must be aware of this and help the parent adhere to their treatment plan.…”

Section: Discussionmentioning

confidence: 99%

When lightning strikes twice: Perceptions of oncology social workers about working with families with two members in treatment

2022

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Objective: Families with a parent and child concurrently receiving cancer treatment are not common, but their needs are typically more complex than families with only one member in treatment. They have a heightened sense of loss, vulnerability, and mortality. The study purpose was to: (1) describe quality of life, social support, resiliency, and loss for these families; and (2) describe how healthcare teams can support these families. Methods:This was a qualitative study with 20 oncology social workers who had worked with families with a parent and child concurrently receiving treatment for cancer within the past five years. The interview included questions about the emotional, social, financial, and other needs of these families, as well as their social support, quality of life, loss, and resiliency.Results: Three themes emerged from the data: 1. Increased demands on the family with a concurrent cancer treatment, including emotional, financial, and logistical challenges for the ill parent and child and for the healthy parent and siblings; 2.Greater resilience and coping skills were experienced by some families; and 3. Implications for the healthcare team, including emotional distress in treating these families, challenges in treatment adherence, and providing the necessary support to these families. Conclusion:Supporting these families is challenging for social workers and other members of the healthcare team. Understanding the emotional, financial and logistical needs of these families, and coordinating their care across the adult and pediatric teams, will better support the patients, as well as the healthcare providers who work with them.

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Motives for non-adherence to colonoscopy advice after a positive colorectal cancer screening test result: a qualitative study

Cited by 12 publications

References 48 publications

Decision‐making in screening positive participants who follow up with colonoscopy in the Dutch colorectal cancer screening programme: A mixed‐method study

Decision‐making in screening positive participants who follow up with colonoscopy in the Dutch colorectal cancer screening programme: A mixed‐method study

Timely Colonoscopy After Positive Fecal Immunochemical Tests in the Veterans Health Administration: A Qualitative Assessment of Current Practice and Perceived Barriers

When lightning strikes twice: Perceptions of oncology social workers about working with families with two members in treatment

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