How sharp can a screening tool be? A qualitative study of patients' experience of completing a bowel cancer screening questionnaire.

Introduction: There is evidence to suggest that the Patient Consultation Questionnaire (PCQ) is a reliable tool to predict symptomatic left-sided colorectal cancer. While previous research has examined the sensitivity and specificity of the PCQ as a tool, it has not addressed patients' perspectives.

Objective: To examine qualitatively patients' perspectives on ease of use of the PCQ, and their attitude to completing it.

Method: The target population were patients in North Wales between 55 and 85 years with colorectal symptoms who had completed the PCQ. A sample of six was randomly selected. The approach was qualitative, using semi-structured, in-depth cognitive interviews, which were recorded and transcribed before content and thematic analysis.

Results: The study found some areas of concern in relation to the PCQ's design and presentation, concerning such issues as the use of medical jargon or ambiguous wording, and the use of questions to which patients may not have an answer. It also found that patients responded to the form as something more than a screening tool, treating it variously as way of speeding up diagnosis and treatment, an opportunity to 'play the system', and a way of bypassing embarrassing encounters.

Discussion And Conclusions: Although major problems were not identified, the minor issues observed in the PCQ's design and presentation may reduce accuracy and patient satisfaction. A greater understanding of patients' perception of the role and function of the PCQ may help clinicians to interpret responses to the form more accurately.