Attitudes towards the Faecal Occult Blood Test (FOBT) versus the Faecal Immunochemical Test (FIT) for colorectal cancer screening: perceived ease of completion and disgust

Abstract

Background: Colorectal cancer screening is key to early detection and thus to early treatment, but uptake is often sub-optimal, particularly amongst lower income groups. It is proposed that the imminent introduction of the single-sample Faecal Immunochemical Test (FIT) in Scotland may lead to increased uptake as compared to the current Faecal Occult Blood Test (FOBT), but underlying reasons are yet to be determined. The aim was to evaluate attitudes and intentions towards completing the FIT compared to the current FOBT for colorectal cancer screening. Methods: A convenience sample of 200 adults (mean age 56.5, range 40-89; 59 % female) living in Scotland rated both the FOBT and the FIT with regard to ease of completion, perceived disgust and intention to complete and return (all measured on Likert-type 1-7 scale). Participants were randomised to be presented (via a face-to-face contact) with either the FIT or FOBT first. Results: Participants reported higher intention to complete and return the FIT versus the FOBT (mean difference 0.62, 95 % CI (0.44, 0.79)). Overall, 85.0 % (n = 170) of participants agreed or strongly agreed that they would intend to complete and return the FIT compared to 65.5 % (n = 131) for the FOBT (χ2 = 20.4, p < .001). The FIT was also perceived to be easier to complete (mean difference 0.85, 95 % CI (0.70, 1.01) and much less disgusting (mean difference 1.11, 95 % CI (0.94, 1.27)). Lower perceived disgust, higher socio-economic status and previous participation in any cancer screening were significant predictors of intention to complete the FOBT, whilst only higher perceived ease of completion predicted intention to complete the FIT. Conclusions: People reported higher intentions to complete and return a FIT than a FOBT test for colorectal cancer screening, largely due to a perception that it is easier and less disgusting to complete. The findings suggest that the introduction of the FIT as standard in the UK could result in a notable increase in screening uptake.