Miles Hannah, Macleod Una, Weller David, Cairns Joanne
Hull York Medical School, University of Hull, Hull, UK.
University of Edinburgh, Edinburgh, UK.
Health Expect. 2025 Aug;28(4):e70315. doi: 10.1111/hex.70315.
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.
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.
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.
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.
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.
在许多高收入国家，肠癌（结直肠癌，CRC）筛查已得到广泛开展。人们对转向基于风险的肠癌筛查以提高筛查效率和效果产生了浓厚兴趣。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）对基于风险的肠癌筛查的态度。
与筛查年龄的公众（英格兰为60 - 74岁；苏格兰为50 - 74岁）和医疗保健专业人员举行了5次虚拟焦点小组会议，以探讨对基于风险的肠癌筛查的态度。公众参与者（n = 12）通过我们现有的患者和公众参与（PPI）网络邀请。医疗保健专业人员（n = 11）通过现有网络并在筛查中心的支持下招募。使用共同创作的信息漫画书来促进关于肠癌风险因素的讨论。转录后，对定性数据进行主题分析。
大家一致认为，对高风险人群进行更密集的筛查是可以接受的，但这并不意味着对低风险人群的筛查减少。公众和医疗保健专业人员在对过度关注风险因素的担忧上有一些共识，这可能对风险因素最小的人不利。人们还希望简化英国各地区现有的肠癌筛查。有人认为，目前的筛查计划以相同方式对待所有风险水平的人，是公平的——如果要改变这一点，就需要进行清晰的沟通。
研究结果表明，人们倾向于对肠癌筛查计划的任何改变都应改进当前的筛查服务，而不是损害为被认为低风险的个人提供的筛查。这些改变需要为公众和医疗保健专业人员所接受——如果不可接受，就有降低肠癌筛查参与率的风险，这可能会加剧筛查结果中的健康不平等。
信息漫画书是与两个患者和公众参与网络共同创作的，即赫尔参与网络以及英国肠癌研究的“人与研究携手共进”网络，由亨伯全民族联盟提供支持。患者和公众参与网络对信息漫画书的开发提供了非常宝贵的反馈，以确保包容性并避免再现与肠癌相关的主导刻板印象。
