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BMC Cancer
Published in: BMC Cancer 1/2016

Open Access 01-12-2016 | Research article

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

Authors: Julie A. Chambers, Alana S. Callander, Rebecca Grangeret, Ronan E. O’Carroll

Published in: BMC Cancer | Issue 1/2016

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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.
Footnotes
1
None of the sample had previously completed a FIT test.
 
2
Cronbach’s α was relatively low for the FIT intention and ease scales, which may be due to the limited number of items. Despite this it is still considered preferable to use multi-item measures for Likert-type scales, rather than single-item measures, which have very poor reliability [17]. We also conducted further examination of these scales which showed that removing the FIT ease item: ‘The instructions for this test are hard to follow’ actually increased Cronbach α to .58 for this scale. We repeated the analyses using the resulting 2-item scale for FIT ease, but all results remained significant as reported. Therefore for consistency of measures between the two tests, we report findings using the original 3-item FIT ease scale.
 
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Metadata
Title
Attitudes towards the Faecal Occult Blood Test (FOBT) versus the Faecal Immunochemical Test (FIT) for colorectal cancer screening: perceived ease of completion and disgust
Authors
Julie A. Chambers
Alana S. Callander
Rebecca Grangeret
Ronan E. O’Carroll
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2016
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-016-2133-4

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