Aims
Bowel cancer is the second biggest cancer killer in New South Wales (NSW)[1], but only two in five eligible NSW residents participate in the National Bowel Cancer Screening Program (NBCSP)[2]. To inform initiatives to increase participation, Cancer Institute NSW conducted research to explore residents’ current bowel cancer screening awareness, knowledge, attitudes and behaviours.
Methods
Guided by the Institute’s Theory of Change Logic Model for bowel cancer screening[3], qualitative research was undertaken with NSW residents eligible to participate in the NBCSP aged 45-64 years in March-April 2025. Twelve online focus groups (n=77) were conducted. In July 2025, quantitative research was conducted via an online cross-sectional survey with NSW residents in the same age range (n=1,050). The qualitative and quantitative responses were analysed using thematic analysis and advanced statistical analyses respectively.
Results
Research participants expressed strong concern about developing cancer, and to a lesser extent, bowel cancer. Structural equation modelling of participants’ quantitative responses identified the six key factors which influence intention to undertake bowel cancer screening including ‘Informed agency and normalised behaviours’, ‘Familiarity with screening’ and ‘Fear of bowel cancer’, and the inter-relationships between factors.
Conclusion
This research showcases unique insights from iterative, mixed method research regarding how fear of bowel cancer, in conjunction with other factors, influences intention to participate in the NBCSP. These valuable learnings can be leveraged to increase prevention and early detection of bowel cancer.