Colorectal Cancer (CRC) is rapidly rising in Asia, but screening uptake remains poor. Although studies
have reported gender differences in screening rates, there have been few studies assessing gender specific
perceptions and barriers towards CRC screening, based on behavioral frameworks. We applied the Health Belief
Model to identify gender-specific predictors of CRC screening in an Asian population.
females had decided to do flexible sigmoidoscopy or
colonoscopy. Staging differences were minimal in
males for all three modalities, while females appeared
to favour both forms of endoscopy over FOBT in their
readiness-to-screen.
Dominant obstructive-cognitive themes - females
Bodily intrusion
Subsumed under this first theme were oral and rectal subthemes,
related primarily to colonoscopy and flexible sigmoidoscopy,
and to a lesser degree, FOBT. The most
notable references were to the oral ingestion of laxative
mixture, perceived as directly intrusive as the actual
endoscopic procedure. While the intrusion of
scoping was perceived to be buffered by tranquilizing
medication, laxative ingestion was seen as not buffered
and as resulting in diarrhoea, gastric distress and numerous
bathroom visits. In terms of scoping intrusion,
most participants had difficulty imagining the level of
pain relief that rendered an endoscopic procedure
relatively painless. FOBT, in contrast, was seen as
indirectly intrusive, given its potential unsanitariness
and the messiness of managing fecal matter, resulting
in exposures to pathogens no less intrusive because
they originated in one’s own body.