Background Singapore’s national colorectal cancer (CRC) screening programme recommends residents complete faecal occult blood testing (FOBT) once a year or a colonoscopy once every 10 years. The transtheoretical model of behaviour change suggests that individuals progress from pre-contemplation (e.g., not thinking about screening) to maintenance (e.g., consistently screening at the recommended frequency). This study sought to understand factors associated with individuals at key stages of the model.

Methods 529 individuals were recruited from a public polyclinic. 109 (20.6%) were in the maintenance stage. Of the 420 pre-maintenance individuals, 143 (34.0%) were in the preparation stage (i.e., never screened but intended to begin). Individuals completed a questionnaire measuring sociodemographic data, behavioural factors based on health belief model (HBM), and sources of screening information.

Results Compared to pre-maintenance, the maintenance group had more males (57.8% versus 41.9%), higher socioeconomic status (22.0% versus 13.4% in private property) and were older (56.2 versus 54.8 years). Compared to preparation, the pre-preparation group had more lower-income individuals (52.9% versus 40.1% earning <S$2000/month). Maintenance and preparation groups scored significantly higher for cues to action and perceived susceptibility versus their respective comparators (p<0.05). Both factors were associated with screening intention and adherence in multivariate regression. More maintenance individuals (74.0% vs 51.8%) received screening information from polyclinics.

Conclusions Increasing perceived susceptibility and consistent cues to screening are crucial for moving individuals into becoming screen-adherent. Nuances relating to socioeconomic status should be further explored.