Increasing compliance with colorectal cancer screening: the development of effective health education.

The ability of a health education leaflet to raise awareness of the frequency of colorectal cancer and its asymptomatic nature and to increase intention to participate in screening with faecal occult blood testing (FOBT) was investigated. One hundred subjects were interviewed before and after reading the leaflet. The number of men stating bowel cancer was 'very common' increased significantly from 20 to 60% (chi 2 = 16.7, P < 0.0001) and those understanding its asymptomatic nature form 64 to 92% (chi 2 = 11.4, P < 0.001). The leaflet significantly increased the percentage of women reporting bowel cancer as 'very common' from 30 to 70% (chi 2 = 16.0, P < 0.0001) and as being asymptomatic from 58 to 94% (chi 2 = 17.8, P < 0.0001). After reading the leaflet, 55% of men who initially declined screening reversed their decision (chi 2 16.5, P < 0.0001) and 50% of female non-adherers reversed their decision (chi 2 = 17.3, P < 0.0001). Reasons most frequently given for declining colorectal cancer screening were feeling well (77% of subjects declining), concern about further tests (38%), unpleasantness of FOBT (13%) and illness (6%). This leaflet successfully educates people about colorectal cancer and increased intention to participate in screening programmes.