Mail-Out Bowel Cancer Screening: Identifying the Behavioural Stumbling Blocks

Research Snapshots of Health Systems and Behavioural Research

What is known?

Bowel cancer is one of the most common causes of cancer related deaths in Australia. However, the good news is, if detected early 90% of bowel cancer cases can be successfully treated.

The National Bowel Cancer Screening Program provides free bowel cancer screening kits to all Australians aged between 50 to 74 years to detect early signs of bowel cancer. Unfortunately, around 60% of people do not return their bowel cancer screening kit. This is often due to screening kits getting forgotten, misplaced or people simply never getting around to it.

It is important for us to identify the exact “stumbling blocks” that prevent someone from returning their kit. In the future, this information will help improve the participation rate, which helps save lives.

What is new?

The results of a recent study showed that there were three main groups of people that don’t complete and return their screening kit:

    1. People who bring the kit into their house but take no further action.
    2. People who open the package and read the bowel cancer information materials but take no further action.
    3. People who read the information and instructions but do not place the kit near the toilet and do not complete and return their bowel cancer screening kit.

When people placed the kit near their toilet (i.e., where the screening kit is used) they were very likely to complete and return it.

What does this mean?

To improve the rate of people using and returning the bowel cancer screening kits, we need to address the three key “stumbling blocks” that prevent them from doing this. Different behaviour change strategies are needed to increase participation for these groups:

  • Mass media campaigns may be necessary to encourage those who do not open or read any of the invitation materials.
  • Improved information and prompts within the kit material may encourage recipients to place their kit near the toilet to facilitate their use.
  • Health initiatives can use this information to increase participation in mail-out bowel cancer screening programs and increase the early detection of bowel cancer screening in Australia.

Cancer Council Queensland is committed to improving bowel cancer prevention and screening programs that help to save lives as we work towards our vision of a cancer free future.

Contact: Larry Myers

Reference: Myers L, Goodwin BC, Ireland M, March S, Aitken J. Mail-out bowel cancer screening: Identifying the behavioural stumbling blocks. Psycho-Oncology. 2021. doi: 10.1002/pon.5866.

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