Public and Healthcare Professional Attitudes Towards Risk-Stratified Bowel Screening: A Qualitative Study Using an Info-Comic Book

IF 3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Health Expectations Pub Date : 2025-07-04 DOI:10.1111/hex.70315

Hannah Miles, Una Macleod, David Weller, Joanne Cairns

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Abstract

Background

Screening for bowel cancer (colorectal cancer, CRC) is well established in many high-income countries. There has been considerable interest in moving towards risk-based bowel screening to increase the efficiency and effectiveness of screening. This UK-based qualitative study explored public and healthcare professionals (HCPs)' attitudes towards risk-based bowel screening.

Methods

Five virtual focus groups were held with members of the public of bowel screening age (60–74 in England; 50–74 in Scotland) and HCPs to explore attitudes towards risk-based bowel screening. Public participants (n = 12) were invited through our existing patient and public involvement (PPI) networks. HCPs (n = 11) were recruited through existing networks and with the support of screening hubs.

A co-created info-comic book was used to facilitate discussion on bowel cancer risk factors. Following transcription, qualitative data were analysed thematically.

Results

There was consensus that more intense screening for those of higher risk is acceptable, but this should not imply less screening for those of lower risk. There was some agreement between the public and HCPs over concerns with undue focus on risk factors, which could disadvantage those with minimal risk factors. There was also a desire to streamline existing bowel screening across the UK nations. It was felt that the current screening programme, by treating people with all risk levels in the same way, is equitable—so clear communication is needed if this is to be changed.

Conclusion

Findings indicate a preference that any changes to the bowel screening programme should enhance the current screening offer, and not compromise screening offered to individuals deemed to be low risk. Changes need to be acceptable to the public and HCPs—if unacceptable, there is a risk of lowering bowel screening uptake, which could potentially exacerbate health inequities in screening outcomes.

Patient and Public Contribution

The info-comic book was co-created with two PPI networks, INVOLVE Hull and People and Research Together, Bowel Research UK, supported by Humber All Nations Alliance. The PPI network provided invaluable feedback on the development of the info-comic book, to ensure inclusivity and avoid the reproduction of dominant stereotypes associated with bowel cancer.

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公众和医疗专业人员对风险分层肠筛查的态度：一项使用信息漫画书的定性研究

背景：在许多高收入国家，大肠癌（结直肠癌，CRC）筛查已经建立。有相当大的兴趣转向基于风险的肠道筛查，以提高筛查的效率和效果。这项基于英国的定性研究探讨了公众和医疗保健专业人员（HCPs）对基于风险的肠道筛查的态度。方法对符合肠道筛查年龄的公众(英国60-74岁；50-74苏格兰)和HCPs探讨对基于风险的肠道筛查的态度。通过我们现有的患者和公众参与（PPI）网络邀请公众参与者（n = 12）。通过现有网络并在筛查中心的支持下招募医护人员（n = 11）。一份共同创作的信息漫画书被用来促进对肠癌风险因素的讨论。转录后，对定性数据进行主题分析。结果人们一致认为，对高风险人群进行更严格的筛查是可以接受的，但这并不意味着对低风险人群进行更少的筛查。公众和医护人员对过度关注风险因素的担忧达成了一些共识，这可能使风险因素最小的人处于不利地位。还有一个愿望是简化英国全国现有的肠道检查。人们认为，目前的筛查方案以同样的方式对待所有风险水平的人，这是公平的——因此，如果要改变这种情况，就需要明确的沟通。结论：研究结果表明，对肠道筛查计划的任何改变都应加强目前的筛查，而不是损害对低风险个体的筛查。改变需要为公众和卫生保健服务提供者所接受——如果不能接受，就有降低肠道筛查接受度的风险，这可能会加剧筛查结果的卫生不公平。这本信息漫画书是由亨伯所有国家联盟支持的两个PPI网络共同创作的，包括赫尔和人民以及英国肠道研究的共同研究。PPI网络为信息漫画书的发展提供了宝贵的反馈，以确保包容性并避免与肠癌相关的主流刻板印象的再现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Expectations 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.20

自引率

9.40%

发文量

251

审稿时长

>12 weeks

期刊介绍： Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.