Young people’s beliefs about the risk of bowel cancer and its link with physical activity

Abstract

Background: the primary aim was to explore young people’s bowel cancer risk appraisals, including whether they had a coherent understanding of the preventative relationship between physical activity (PA) and bowel cancer. A secondary aim was to examine the fit of the Illness Risk Representations Framework (IRR) to beliefs underlying bowel cancer risk appraisals. Methods: Qualitative design. Semi-structured interviews with 25 people aged 14-17 years. Framework analysis employed. Findings: Themes reflected the five illness risk attributes of the IRR. Identity: participants believed that those with a family history of (bowel) cancer were most at risk, a factor largely absent amongst the group. Cause: participants suggested lifestyle causes relating to foods/drinks ingested hypothesising the need for direct contact between a harmful substance and the bowel. Most felt that their current lifestyle choices reduced their future risk. The link between PA and bowel cancer was unknown and difficult to fathom. Timeline: bowel cancer was perceived as a disease of ageing and therefore a distal problem. Consequences: were most frequently identified as emotional and financial. Few talked about the effects on health and wellbeing. Control: All participants knew bowel cancer was potentially fatal. They were uncertain how treatable it was but knew that only conventional medicine would work. Discussion: Interventions should aim to make future risk of bowel cancer more tangible and the full range of consequences understood, provide coherent explanations of how preventative efforts work, and emphasise the typical late presentation of symptoms which reduce treatability. The IRR fit the data well.