Barriers for Participation in the Danish Colorectal Cancer Screening Program: a Qualitative Study

Sofie Phillipsen*, Louise Kongsmark Weltz, Jannie Dressler, Marie Konge Nielsen, Morten Rasmussen, Lars Nannestad Jorgensen, Anna Thit Johnsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Purpose: The participation rate in the Danish National Screening Program for Colorectal Cancer is around 60%. Since early detection of cancer through the colorectal cancer screening program (CRCS) reduces mortality rates, it is important to understand why people do not participate. The aim of this study was therefore to examine in depth why some people do not participate in the Danish CRCS program. 

Methods: Individual semi-structured interviews were conducted with 18 people who had not participated in the national CRCS program. Data was analyzed using an inductive hermeneutic approach. 

Results: The analysis uncovered three main themes describing barriers to screening: (a) the accountability for ensuring personal health covered the following sub-themes: (i) when invitation is out of sight it is out of mind, (ii) aversion against own stool sample collection, and (iii) the perceived risk of getting colorectal cancer (CRC); (b) attitudes towards the healthcare system and its organization covered the following sub-themes: (i) positivity towards CRCS, (ii) trust in the healthcare system, (iii) lack of internal communication in the healthcare system, and (iv) wish for involvement of the general practitioner (GP); (c) knowledge about disease and screening covered the following sub-themes: (i) knowledge about CRC and CRCS, (ii) wish for information via new channels, and (iii) CRC is rarely something you talk about. 

Conclusion: Among the informants included in this study, lack of participation in the CRCS program was not due to an active opt-out, as most informants had intentions of participating. The informants thought it would motivate them to participate if their GP would remind them of the screening program.

Original languageEnglish
JournalJournal of Gastrointestinal Cancer
Issue number3
Pages (from-to)873-881
Publication statusPublished - Sept 2023


  • Barriers
  • Colorectal cancer
  • Qualitative study
  • Screening
  • Colorectal Neoplasms/diagnosis
  • Mass Screening
  • Early Detection of Cancer
  • Humans
  • Denmark


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