Emotional predictors of bowel screening: the avoidance-promoting role of fear, embarrassment, and disgust

Abstract

BackgroundDespite considerable efforts to address practical barriers, colorectal cancer screening numbers are often low. People do not always act rationally, and investigating emotions may offer insight into the avoidance of screening. The current work assessed whether fear, embarrassment, and disgust predicted colorectal cancer screening avoidance.MethodsA community sample (N = 306) aged 45+ completed a questionnaire assessing colorectal cancer screening history and the extent that perceptions of cancer risk, colorectal cancer knowledge, doctor discussions, and a specifically developed scale, the Emotional Barriers to Bowel Screening (EBBS), were associated with previous screening behaviours and anticipated bowel health decision-making.ResultsStep-wise logistic regression models revealed that a decision to delay seeking healthcare in the hypothetical presence of bowel symptoms was less likely in people who had discussed risk with their doctor, whereas greater colorectal cancer knowledge and greater fear of a negative outcome predicted greater likelihood of delay. Having previously provided a faecal sample was predicted by discussions about risk with a doctor, older age, and greater embarrassment, whereas perceptions of lower risk predicted a lower likelihood. Likewise, greater insertion disgust predicted a lower likelihood of having had an invasive bowel screening test in the previous 5 years.ConclusionsAlongside medical and demographic factors, fear, embarrassment and disgust are worthy of consideration in colorectal cancer screening. Understanding how specific emotions impact screening decisions and behaviour is an important direction for future work and has potential to inform screening development and communications in bowel health.

An investigation of the emotion of disgust as an affective barrier to intention to screen for colorectal cancer

“…A study limitation is that the EBBS is not a published scale (Reynolds et al., ). However, in the present study, although it was not a reliable tool for identifying discrete emotions, the EBBS did detect faecal disgust‐based emotional reactions to bowel screening.…”

“…The emotional barriers to bowel screening (EBBS) were administered to assess emotional responses to bowel screening (Reynolds, Bissett, Reid, & Consedine, ). The scale adopts a 5‐point agreement scale (1 = strongly disagree , and 5 = strongly agree ), across 20 items.…”

Genitalia-related nursing embarrassment and its associated factors among female nurses in mainland China: a nationwide cross-sectional study

“…Medical procedures that are intimate, such as colonoscopies and pelvic/prostate examinations, can cause discomfort and embarrassment for patients. Previous studies have reported that the embarrassment experienced during these situations can prevent patients from engaging in medical examinations (1,2).…”

Development and psychometric evaluation of the colostomy disgust scale in patients with colostomy

“…colonoscopy insertion, surgical incision and wound appearance), hygiene (e.g. unpleasant odour) and death (Haidt, McCauley, & Rozin, 1994; Reynolds, Bissett, & Consedine, 2018; Reynolds, Consedine, & McCambridge, 2014). Given its evolutionary grounding as a vital element of the “behavioural immune system” (Schaller & Park, 2011), disgust is particularly relevant in facilitating psychological reactions to disease and its treatment (Reynolds, Consedine, Pizarro, & Bissett, 2013).…”