Bowel cancer screening in an English prison: a qualitative service evaluation

S. Blagden*, C. Simpson, M. Limmer

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    1 Citation (Scopus)


    Objectives: Bowel cancer screening home-testing kits are offered every two years to individuals aged 60–74 years in the United Kingdom (UK), with prisoners eligible for screening in the same way as the general population. There are currently major changes planned to the bowel cancer screening programme in England, with the transition to the single-sample faecal immunochemical test (FIT) and the planned lowering of the age limit from 60 to 50 years. In this project, we aimed to explore processes and beliefs around bowel cancer screening in an English prison. 

    Study design: This is a qualitative study. 

    Methods: Semistructured qualitative interviews were conducted with eight prisoners and four staff members in a male prison in North West England. Data were analysed via thematic analysis. 

    Results: Promoting and impeding factors to screening were identified. There was high willingness amongst prisoners to be screened for bowel cancer, with screening seen as important and having benefits for the individual and healthcare system. However, there was often low awareness of screening and there were psychological challenges associated with screening. Prison healthcare staff were widely respected and were a motivator to accept screening, with prisoners viewing prison as a good opportunity to access health care. Despite this, prison life was characterised by competing priorities, with security taking precedence, and screening sometimes a low priority for staff and prisoners. There were also considerable logistical challenges to delivering bowel cancer screening in a prison, and the system was not comparable with that in the community. Providing good-quality understandable information, though challenging, was key. 

    Conclusions: This is the first project to explore entering the bowel cancer screening programme in UK prisons, and promoting and impeding factors to the take-up of screening have been identified. This information could be practically used by local commissioners and policymakers to aid the design of staff and prisoner interventions to maximise uptake of bowel cancer screening in prisons. As the planned changes to bowel cancer screening in England are likely to increase the number of eligible prisoners, this work could also be used to inform any service reconfiguration required to accommodate these changes.

    Original languageEnglish
    Pages (from-to)46-50
    Number of pages5
    JournalPublic Health
    Early online date16 Dec 2019
    Publication statusPublished - Mar 2020

    Bibliographical note

    Funding Information: Service evaluation approval for this project was obtained from the Public Health England Research Ethics and Governance Group (approval reference number NR0143) and the Bowel Cancer Screening Programme Research Advisory Committee (reference: BCSP RAC 249).

    Open Access: No Open Access licence

    Publisher Copyright: © 2019 The Royal Society for Public Health

    Citation: S. Blagden, C. Simpson, M. Limmer, Bowel cancer screening in an English prison: a qualitative service evaluation, Public Health, Volume 180, 2020, Pages 46-50, ISSN 0033-3506.



    • Bowel cancer
    • Prison health
    • Screening


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