A study looking at attitudes to health and bowel screening in Scotland (ARTICS)

Cancer type:

Bowel (colorectal) cancer





This study tested a simple method aimed at increasing the number of people who take part in bowel screening in Scotland. 

This study was open for people to join between April and June 2013. The team published the results in 2015.

More about this trial

Bowel cancer screening aims to detect bowel cancer at an early stage. This is when treatment is more likely to work. 

In Scotland, people aged between 50 and 74 years old receive a stool testing kit every 2 years. This is the faecal immunochemical test or FIT (used to be the faecal occult blood test or FOBT). Just over half of the people complete and return their kit. 

Researchers wanted to know how people felt about taking part in bowel screening. They sent questionnaires to people who received a stool testing kit.

They asked people to consider possible or anticipated regret. This was about not returning the kit and then developing cancer and not having found it earlier.

The team wanted to know if anticipated regret increased the likelihood that people would return the test. 

Summary of results

The team found there were mental and emotional factors that influenced people’s intention on doing and returning the bowel screening test. However anticipated regret did not increase the number of test kits returned.

Study design 

Everyone received the standard letter about FOBT. With the standard letter the team sent out 2 questionnaires to some of the people. 

One was the health locus of control (HLOC) questionnaire. The questions asked their beliefs about:

  • screening
  • control of their health

The other was about the possible regret of not having done the screening test. This is the anticipated regret (AR) questionnaire.

There were 3 groups: 

  • 19,797 didn’t get any questionnaires. This was the control group Open a glossary item.  
  • 20,040 people received the HLOC questionnaire
  • 20,163 people received both the HLOC and AR questionnaires

The team looked at whether people intended to do and return the test. 

Of the 19,797 people in the control group 19,604 returned the test. 

Of the 20,040 people who received the HLOC questionnaire 19,828 returned the test and the questionnaire. 

Of the 20,163 people who received both questionnaires 19,934 returned the test and both questionnaires. 

The team looked at the answers to the AR questionnaire. They found that anticipated regret didn’t directly affect people’s intention to do and return the test. 
Part of the questionnaire asked the people if they felt any disgust about doing the test. The team looked at whether this affected their intention to do the test. 

They found that the level of disgust people felt did affect their intention to do the test. The team said that this supported previous evidence that disgust was a major barrier to bowel screening. 

Anticipating regret about not participating did not increase the number of test kits returned. However, anticipated regret and disgust were important factors. These indirectly affected the number of people who did the bowel screening test. 

The researchers said that anticipated regret might be a good way to get people to do something. However the method they used in the study was not effective. The team suggested that further work should be done. This could look at different methods of using anticipated regret to increase the number of people who do and return the FIT test. 

More detailed information
There is more information about this research in the reference below. 

Please note, this article is not in plain English. It has been written for health care professionals and researchers.

Journal articles
Anticipated regret to increase uptake of colorectal cancer screening
(ARTICS): A randomised controlled trial

R E O’Carroll, J A Chambers, L Brownlee, G Libby, R J C Steele

Social Science and Medicine, 2015. volume 142, pages 118-127
Where this information comes from    

We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Ronan O'Carroll

Supported by

Chief Scientist Office (CSO)
National Institute for Health Research Cancer Research Network (NCRN)
Scottish Bowel Screening Programme
University of Stirling

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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