Different faecal sampling methods alter the acceptability of faecal occult blood testing: a cross sectional community survey

BackgroundA bowel cancer screening programme is being introduced in the UK. The programme will screen men and women aged 60–69 using faecal occult blood testing (FOBt). Uptake rates in the pilot evaluation were <60%. This study aimed to determine whether the acceptability of FOBt is associated with the sampling method or previous exposure to FOBt.MethodsPostal questionnaire assessing the perceived acceptability of three potential methods of FOBt sampling: (1) sterile transport swab; (2) smear card [as used in the national screening roll-out]; (3) faecal specimen pot [routinely used in the NHS for stool samples]. Study population comprised those aged 50–69.ResultsResponse rate was 63%. FOBt was reported as acceptable by 94.5%. Acceptability fell significantly when sampling methods were detailed. The swab was rated more acceptable than the card or the pot (90.2% versus 62.9% versus 63.0%, p < 0.0005). FOBt acceptability did not vary with previous experience of FOBt.ConclusionsThe acceptability of FOBt varied by the sampling method described. The smear card, such as that used in the national screening programme, was the least preferred method. To increase the uptake of screening, alternative methods of faecal sampling should be considered.