Worldwide, colorectal cancer (CRC) is a leading cause of cancer mortality. Uptake of CRC screening is an important performance indicator that exerts a direct impact on programme success. We aimed to examine whether the Theory of Planned Behaviour (TPB) can predict the uptake of CRC screening that could further inform new strategies in the promotion of screening of its uptake in the general population.Methods
A population-based telephone survey was conducted in 2017. Individuals aged 61–70 years were randomly recruited. A total of 2400 eligible respondents were recruited, consisting of 1200 participants and 1200 non-participants of the government-subsidised CRC screening programme. A questionnaire validated by an expert panel of epidemiologists, gastroenterologists and public health practitioners was used to measure the attitudes towards CRC screening; normative beliefs; perceived behavioural control and intention for each participant. The association between CRC screening uptake and the factors pertinent to TPB was analysed by binary logistic regression analysis that adjusted for age, gender, education level, and household income.Results
The characteristics of respondents were shown in table 1. Multivariate regression model showed that high perceived behavioural control (AOR=5.94, 95% CI=4.76–7.41, p<0.001), high intention for CRC screening (AOR=3.03, 95% CI=2.39–3.83, p<0.001) and positive attitude towards CRC screening (direct measurement: adjusted odds ratio (AOR)=1.26, 95% confidence interval (CI)=1.10–1.45, p<0.001; for indirect measurement: AOR=1.23, 95% CI=1.08–1.41, p<0.01) were significantly associated with CRC screening uptake (table 2).Conclusions
The variables pertinent to the TPB could successfully predict the uptake of CRC screening. Promotion of CRC screening based on enhancing perceived behavioural control as well as behavioural intention could be effective in increasing screening uptake. Further studies are needed to establish a cause-and-effect relationship between these variables and uptake, as well as to evaluate the cost-effectiveness of such interventions.