Perceived Threat and Internet Use Predict Intentions to Get Bowel Cancer Screening (Colonoscopy): Longitudinal Questionnaire Study

Abstract

BackgroundMany people use the Internet for health-related information search, which is known to help regulate their emotional state. However, not much is known yet about how Web-based information search together with negative emotional states (ie, threat of cancer diagnosis) relate to preventive medical treatment decisions (ie, colonoscopy intentions).ObjectiveThe aim of this study was to investigate how frequency of health-related Internet use together with perceived threat of a possible (bowel) cancer diagnosis influences intentions to get a colonoscopy. Previous research has shown that people who experience threat preferentially process positive information in an attempt to downregulate the aversive emotional state. The Internet can facilitate this regulatory strategy through allowing self-directed, unrestricted, and thus biased information search. In the context of threat regarding a possible bowel cancer diagnosis, feelings of threat can still be effectively reduced through cancer screening (ie, colonoscopy). We, therefore, predict that in that particular context, feelings of threat should be related to stronger colonoscopy intentions, and that this relationship should be enhanced for people who use the Internet often.MethodsA longitudinal questionnaire study was conducted among healthy participants who were approaching or just entering the bowel cancer risk group (aged 45-55 years). Perceived threat of a possible (bowel) cancer diagnosis, frequency of health-related Internet use, and intentions to have a colonoscopy were assessed at 2 time points (6-month time lag between the 2 measurement points T1 and T2). Multiple regression analyses were conducted to test whether threat and Internet use at T1 together predicted colonoscopy intentions at T2.ResultsIn line with our predictions, we found that the threat of a possible (bowel) cancer diagnosis interacted with the frequency of Internet use (both T1) to predict colonoscopy intentions (T2; B=.23, standard error [SE]=0.09, P=.01). For people who used the Internet relatively often (+1 SD), the positive relationship between threat and colonoscopy intentions was significantly stronger (B=.56, SE=0.15, P<.001) compared with participants who used the Internet less often (−1 SD; B=.17, SE=0.09, P=.07). This relationship was unique to Web-based (vs other types of) information search and independent of risk factors (eg, body mass index [BMI] and smoking).ConclusionsThe results of this study suggest that health-related Internet use can facilitate emotion-regulatory processes. People who feel threatened by a possible (bowel) cancer diagnosis reported stronger colonoscopy intentions, especially when they used the Internet often. We propose that this is because people who experience threat are more likely to search for and process information that allows them to downregulate their aversive emotional state. In the present case of (bowel) cancer prevention, the most effective way to reduce threat is to get screened.

Threatened individuals prefer positive information during Internet search: An experimental laboratory study

“…Threat and other similarly negative affective states are known to elicit a preference for positive information (Rothermund, Voss, & Wentura, 2008;Schwager & Rothermund, 2013aShepperd, Malone, & Sweeny, 2008;Taylor, 1991; for an overview see Jonas et al, 2014). This positive bias has recently also been demonstrated for Internet search (e.g., Becker, Grapendorf, Greving, & Sassenberg, 2018;Greving, Sassenberg, & Fetterman, 2015;Sassenberg & Greving, 2016). …”

“…These hypotheses were derived from previous research on threat (Becker et al, 2018;Sassenberg & Greving, 2016; see also Blascovich & Tomaka, 1996;Jonas et al, 2014;Rothermund, 2011). As we had clear predictions that the results for threat should be different from the two control conditions and that the two control conditions should not differ in positive bias in link selection and webpage scanning, we conducted orthogonal contrast analyses (e.g., Davis, 2010).…”

“…Secondly, future research could investigate not only the Internet search process. Searching the Internet for information often implies that a decision needs to be made (e.g., Fox & Duggan, 2013;Fox & Jones, 2009;Lo & Parham, 2010; see also Becker et al, 2018). Therefore, future research could also address the question whether the preference for positive information under threat also applies to actual decision making resulting from Internet searches.…”

“…Healththreatened individuals for their part may need to be aware of the ambivalent consequences of their Internet search. On the one hand, their preference for positive information may provide them with quite relevant emotional support (Lazarus & Folkman, 1984) in dealing with the health-related threat (e.g., Becker et al, 2018;Sassenberg & Greving, 2016). On the other hand, due to preferring positive information, health-threatened individuals may run the risk to make wrong or suboptimal decisions based on their Internet search (Fox & Duggan, 2013;Fox & Jones, 2009;Lo & Parham, 2010;Murray et al, 2003).…”

Using Decision Tree Aggregation with Random Forest Model to Identify Gut Microbes Associated with Colorectal Cancer

“…Early detection can significantly improve the overall survival of CRC patients. Colonoscopy is by far the most accurate colon cancer diagnosis method but, because of the discomfort caused by its intrusiveness, many people are reluctant to undergo the procedure [ 11 , 12 ]. The fecal occult blood test (FOBT) [ 13 ] is another clinical tool for identifying colorectal cancer, which has the advantages of being both noninvasive and economical.…”