Exploring the acceptability of the faecal immunochemical test (FIT) versus a blood test for detecting colorectal cancer: a qualitative study

Background Uptake of bowel cancer screening using the faecal immunochemical test (FIT) remains lower among some underrepresented populations. CanSense Ltd. (Swansea, UK) has developed a blood-based colorectal cancer (CRC) test as a potential alternative. This study explored perceptions of blood-based CRC testing compared with the FIT among ethnic minority communities in Wales.Methods Two focus groups were conducted with 16 participants from ethnic minority backgrounds using a semi-structured topic guide. Participants received explanations of the FIT and CanSense-CRC blood test and discussed anticipated acceptability rather than actual use. Discussions explored barriers to FIT uptake and perceptions of blood-based testing. Data were analyzed using the Theoretical Framework of Acceptability.Results Participants identified challenges associated with the FIT, including handling stool samples and limited awareness of bowel cancer symptoms. Many preferred the blood test, particularly if considered accurate and reliable. Familiarity with blood testing and perceived convenience influenced acceptability.Conclusions Blood-based CRC testing may be perceived as more acceptable than the FIT among some South Asian Muslim participants and other groups facing barriers to stool-based testing. However, findings reflect anticipated acceptability and require validation through real-world implementation studies.