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Title: Factors predicting improved compliance towards colonoscopy in individuals with positive faecal immunochemical test (FIT)
Authors: Lim, Tian-Zhi
Lau, Jerrald 
Wong, Gretel Jianlin 
Tan, Lavine Yen-Ting
Chang, Yu-Jing
Natarajan, Karthiga
Yi, Huso 
Wong, Mee-Lian 
Tan, Ker-Kan 
Keywords: colorectal cancer
health belief model
Issue Date: 14-Sep-2021
Publisher: John Wiley and Sons Inc
Citation: Lim, Tian-Zhi, Lau, Jerrald, Wong, Gretel Jianlin, Tan, Lavine Yen-Ting, Chang, Yu-Jing, Natarajan, Karthiga, Yi, Huso, Wong, Mee-Lian, Tan, Ker-Kan (2021-09-14). Factors predicting improved compliance towards colonoscopy in individuals with positive faecal immunochemical test (FIT). Cancer Medicine 10 (21) : 7735-7746. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Objectives: Follow-up colonoscopy after a positive faecal immunochemical test (FIT) in any colorectal cancer (CRC) screening programme is integral. However, many individuals who had a positive FIT declined colonoscopy subsequently. This study aims to uncover the predictors on completion of colonoscopy using the Health Belief Model (HBM) between individuals who complete and those who did not after a positive FIT. Methods: A mixed-method study comprising qualitative semi-structured interviews followed by a locally validated questionnaire in Singapore was prospectively administered via telephone interview to average risk individuals with positive FIT results from a cohort of the national FIT screening database referred for follow-up colonoscopic evaluation. Results: A total of 394 individuals, with a median age of 66 years (range, 46–89 years), were recruited. Fifty percent completed follow-up colonoscopic evaluation and formed the “doers” group. All participants demonstrated high knowledge of symptoms of CRC and awareness and qualitative responses were aligned to the various HBM domains. Using multi-variable analysis, doers felt that medical recommendations (odds ratio [OR], 2.39, 95% confidence interval [CI]: 1.23–4.63, p = 0.01) and mainstream media publicity (OR, 2.16, 95% CI: 1.09–4.26, p = 0.026) were important. Non-doers showed positive association with perceived barriers such as cost (OR, 2.15, 95% CI: 1.10–4.20, p = 0.026) and inconvenience (OR, 3.44, 95% CI: 1.50–7.89, p = 0.004). Conclusions: Identified factors such as tackling perceived barriers, public health education and active promotion by medical physicians, family and friends could help guide subsequent interventions to improve compliance of individuals with positive FIT to undergo follow-up colonoscopy. © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Source Title: Cancer Medicine
ISSN: 2045-7634
DOI: 10.1002/cam4.4275
Rights: Attribution 4.0 International
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