{
  "abstract": "Introduction Faecal Immunochemical Testing (FIT) is now an established step in the appraisal, investigation and diagnosis of patients presenting in primary care with symptoms of possible colorectal cancer (CRC). However, a significant proportion of patients do not return their test, with non – or late - return more common in socio-demographic groups who are already known to experience cancer inequalities, both in their diagnostic pathways and outcomes.It is important to identify and understand the factors that prevent (timely) completion of symptomatic FIT in order to develop mechanisms to increase completion rates and avoid exacerbating CRC inequalities for marginalised populations.Methods Symptomatic patients in the Northeast of England who had not returned a GP-requested FIT were identified and invited to participate in an interview. Interviews took place remotely (telephone or video call), were audio recorded and transcribed. Transcripts were thematically analysed, entailing line-by-line coding, followed by development and refinement of themes by the wider research team.Results Non-completion of FIT was rarely an active decision, but usually the result of a combination of factors that meant the sample was not collected, or posted. For many people competing priorities (children, work) caused procrastination in test completion, coupled with disgust at the thought of handling their stool, or fear of a cancer diagnosis hindering test completion for some. After they received the kit a number of participants received a diagnosis for another condition, or their symptoms resolved, which consolidated their decision not to complete the test. For others, mental health problems, including anxiety, added to test completion reluctance, or procrastination, with frailty and dexterity issues also reported by a small few as a barrier to test completion. There was confusion amongst some participants about the test purpose, with some perceiving symptomatic and screening FIT to be equivalent, unaware of the different implications for access to colonoscopy of the two test routes. For some people who had recently completed a bowel cancer screening FIT they believed it to be unnecessary to ‘repeat’ the test initiated from their symptomatic presentation.Conclusion A number of barriers to test completion have been identified, including practical, emotional, logistical and disease factors. Working with patients to explain the importance of test completion (particularly those who are actively participating in the bowel cancer screening programme) and identifying mechanisms to reduce procrastination, may increase FIT completion and improve timeliness of diagnosis for some patients with CRC.",
  "authors": [
    {
      "affiliations": [
        "Newcastle University, Queen Victoria Road, United Kingdom"
      ],
      "name": "Christina Dobson"
    },
    {
      "affiliations": [
        "Newcastle University, Queen Victoria Road, United Kingdom"
      ],
      "name": "Emily Haworth"
    },
    {
      "affiliations": [
        "Newcastle University, Queen Victoria Road, United Kingdom"
      ],
      "name": "Adam Biran"
    },
    {
      "affiliations": [
        "Newcastle University, Queen Victoria Road, United Kingdom"
      ],
      "name": "Linda Sharp"
    },
    {
      "affiliations": [
        "Newcastle University, Queen Victoria Road, United Kingdom"
      ],
      "name": "Colin Rees"
    }
  ],
  "title": "P331 Why do some people with colorectal cancer symptoms not complete FIT? A qualitative interview study",
  "uid": "a5519f50-234e-5a7a-895a-e6a4447edb04"
}