Bridging the gap: enhancing qFIT bowel screening uptake in deprived areas

Background Bowel cancer is the UK’s second biggest cancer killer, accounting for around 16,000 deaths annually. The quantitative faecal immunochemical test (qFIT) has massively improved early detection of bowel cancer, yet uptake remains significantly lower in socioeconomically deprived areas. Aim To explore the barriers to qFIT uptake in deprived communities and identify public health initiatives that could improve screening participation. Method A narrative review of national screening data, public health reports, and previous interventions aimed at increasing screening uptake in deprived communities was conducted. Key factors explored included health literacy, cultural attitudes, language barriers and access to healthcare. Results In Scotland, bowel screening uptake between 2022–24 exceeded the 60% target overall. However, inequalities remain, with only 52.9% of people in the most deprived areas participating compared with 74.7% in affluent communities. Barriers to completing qFITs include low health literacy, language barriers, cultural sensitivities, and embarrassment. Evidence from other regions shows targeted interventions can improve uptake: the Lancashire ‘Call for a Kit’ initiative increased return rates to 71.5%, while NHS England’s ‘Your next poo could save your life’ campaign raised uptake in London from 63% to 69% Conclusion Enhancing qFIT uptake in deprived areas requires a multifaceted strategy, as low participation stems from a range of barriers. Key measures include simplifying health information, tackling stigma, addressing linguistic and cultural challenges, and implementing large-scale awareness campaigns to reach wider audiences. Normalising bowel screening, reducing barriers, and easing pressure on primary care are key to earlier detection and survival.