Predictors of bowel scope (flexible sigmoidoscopy) screening knowledge: findings from a retrospective survey

Abstract

Background: Nearly 6 in 10 people do not accept their invitation to participate in the new Bowel Scope (Flexible Sigmoidoscopy) Screening programme (BSSP). In this study we investigate predictors of screening knowledge in previous BSS invitees. Method: Individuals invited to attend BSS between March 2013 and February 2015 were identified through GP records (n = 3227) and sent a questionnaire assessing screening knowledge (9 item scale), engagement with information and attendance. Multivariate regression was used to identify predictors of knowledge. Findings: 1477 (45.8%) completed questionnaires were returned. Of the 1366 (92.5%) suitable for analysis, the majority were female (52.6%), married or cohabiting (78.8%), White (91.7%), fell within the least deprived SES group (77.0%) and had read the delivered information about BSS (87.3%) and attended their appointment (80.8%). Knowledge scores were generally low (m = 5.08; range = 0-9), but lower among non-attenders (4.45) than attenders (5.23; p = <0.001), and higher in those who had read the information (m = 5.12) than those who did not (m = 4.47; p = <0.001). Mean knowledge scores were socially graded (ranging from 5.21 in high SES to 4.37 in low SES groups; p<0.001). Regression analysis confirmed that attendance, reading the provided BSS information and SES all independently predicted knowledge scores. Discussion: We found BSS knowledge to be low among people recently invited, particularly among those who decided not to attend. The social gradient in knowledge suggests information materials need to be more accessible in order to avoid potential SES inequalities in participation.