Understanding Patient Factors to Increase Uptake of Cancer Screening: a Review

Young, Ben; Robb, Kathryn A.

doi:10.2217/fon-2020-1078

Cited by 32 publications

(31 citation statements)

References 160 publications

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“…Similarly, people who perceive the FIT as easy to complete may think this way because they have more solutions to overcoming FIT barriers. The greater number of solutions endorsed among people living in deprived areas is contrary to consistently lower colorectal screening uptake in this group 26 30. This finding may suggest that people living in deprived areas who complete the FIT engage in more problem-solving than people living in affluent areas.…”

Section: Discussionmentioning

confidence: 63%

“…Our findings suggest that they may experience fewer barriers to screening than people who are unsure whether their family or friends have had cancer. Women reported more barriers, which is not reflected in the UK literature,26 29 but matches lower uptake rates among women of FOBt and colonoscopy 30. Yet, women endorsed significantly more solutions than men.…”

Section: Discussionmentioning

confidence: 80%

“…Akin to existing evidence, younger and single participants and those with low self-efficacy experienced more screening barriers 8 26. Previous research shows that people with family or friends with cancer are more likely to complete screening 27 28.…”

Section: Discussionmentioning

confidence: 95%

“…The greater number of solutions endorsed among people living in deprived areas is contrary to consistently lower colorectal screening uptake in this group. 26 30 This finding may suggest that people living in deprived areas who complete the FIT engage in more problem-solving than people living in affluent areas. Consequently, people living in deprived areas who do not complete the FIT may need more support with this same problem-solving.…”

Section: Discussionmentioning

confidence: 99%

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What are common barriers and helpful solutions to colorectal cancer screening? A cross-sectional survey to develop intervention content for a planning support tool

et al. 2022

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ObjectiveColorectal screening using faecal immunochemical tests (FITs) can save lives if the people invited participate. In Scotland, most people intend to complete a FIT but this is not reflected in uptake rates. Planning interventions can bridge this intention-behaviour gap. To develop a tool supporting people willing to do colorectal screening with planning to complete a FIT, this study aimed to identify frequently experienced barriers and solutions to these barriers.DesignThis is a cross-sectional study.SettingParticipants were recruited through the Scottish Bowel Screening Programme to complete a mailed questionnaire.ParticipantsThe study included 2387 participants who had completed a FIT (mean age 65 years, 40% female) and 359 participants who had not completed a FIT but were inclined to do so (mean age 63 years, 39% female).Outcome measuresThe questionnaire assessed frequency of endorsement of colorectal screening barriers and solutions.ResultsParticipants who had not completed a FIT endorsed significantly more barriers than those who had completed a FIT, when demographic, health and behavioural covariates were held constant (F(1,2053)=13.40, p<0.001, partial η2=0.01). Participants who completed a FIT endorsed significantly more solutions than those who did not (U=301 585.50, z=−3.21, p<0.001, r=0.06). This difference became insignificant when covariates were controlled. Participants agreed on the most common barriers and solutions regardless of screening history. Barriers included procrastination, forgetting, fear of the test result, screening anxiety, disgust and low self-efficacy. Solutions included hand-washing, doing the FIT in private, reading the FIT instructions, benefit of early detection, feelings of responsibility, high self-efficacy and seeing oneself as a person who looks after one’s health.ConclusionThis survey identified six barriers and seven solutions as key content to include in the development of a planning tool for colorectal screening using the FIT. Participatory research is required to codesign an engaging and accessible planning tool.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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What are common barriers and helpful solutions to colorectal cancer screening? A cross-sectional survey to develop intervention content for a planning support tool

et al. 2022

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“…High participation rates are essential for screening programmes to be (cost-)effective [ 10 , 11 ]. According to the World Health Organization (WHO), at least 70% of the target population should be screened in order to be beneficial on population level [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Perspectives on cancer screening participation in a highly urbanized region: a Q-methodology study in The Hague, the Netherlands

et al. 2022

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Background The Netherlands hosts, as many other European countries, three population-based cancer screening programmes (CSPs). The overall uptake among these CSPs is high, but has decreased over recent years. Especially in highly urbanized regions the uptake rates tend to fall below the minimal effective rate of 70% set by the World Health Organization. Understanding the reasons underlying the decision of citizens to partake in a CPS are essential in order to optimize the current screening participation rates. The aim of this study was to explore the various perspectives concerning cancer screening among inhabitants of The Hague, a highly urbanized region of the Netherlands. Methods A Q-methodology study was conducted to provide insight in the prevailing perspectives on partaking in CSPs. All respondents were inhabitants of the city of The Hague, the Netherlands. In an online application they ranked a set of 31 statements, based on the current available literature and clustered by the Integrated Change model, into a 9-column forced ranking grid according to level of agreement, followed by a short survey. Respondents were asked to participate in a subsequent interview to explain their ranking. By-person factor analysis was used to identify distinct perspectives, which were interpreted using data from the rankings and interviews. Results Three distinct perspectives were identified: 1). “Positive about participation”, 2). “Thoughtful about participation”, and 3). “Fear drives participation”. These perspectives provide insight into how potential respondents, living in an urbanized region in the Netherlands, decide upon partaking in CSPs. Conclusions Since CSPs will only be effective when participation rates are sufficiently high, it is essential to have insight into the different perspectives among potential respondents concerning partaking in a CSP. This study adds new insights concerning these perspectives and suggests several ideas for future optimization of the CSPs.

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The role of defensive information processing in population‐based colorectal cancer screening uptake

Clarke

Hayes

McQueen

et al. 2023

Cancer

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Background: Internationally, colorectal cancer screening participation remains low despite the availability of home-based testing and numerous interventions to increase uptake. To be effective, interventions should be based on an understanding of what influences individuals' decisions about screening participation. This study investigates the association of defensive information processing (DIP) with fecal immunochemical test (FIT)-based colorectal cancer screening uptake. Methods: Regression modeling of data from a cross-sectional survey within a population-based FIT screening program was conducted. The survey included the seven subdomains of the McQueen DIP measure. The primary outcome variable was the uptake status (screening user or nonuser). Multivariable logistic regression was used to estimate the odds ratio (OR) for screening nonuse by DIP (sub)domain score, with adjustments made for sociodemographic and behavioral factors associated with uptake.Results: Higher scores (equating to greater defensiveness) on all DIP domains were significantly associated with lower uptake in the model adjusted for sociodemographic factors. In the model with additional adjustments for behavioral factors, the suppression subdomains of "deny immediacy to be tested" (OR, 0.53; 95% confidence interval [CI], 0.43-0.65; p < .001) and "self-exemption" (OR, 0.80; 95% CI, 0.68-0.96; p < .001) independently predicted nonuse of FIT-based screening.Conclusions: This is the first study outside the United States that has identified DIP as a barrier to colorectal cancer screening uptake, and it is the first focused specifically on FIT-based screening. The findings suggest that two suppression barriers, See editorial on pages 1156-8, this issue.

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Understanding Patient Factors to Increase Uptake of Cancer Screening: a Review

Cited by 32 publications

References 160 publications

What are common barriers and helpful solutions to colorectal cancer screening? A cross-sectional survey to develop intervention content for a planning support tool

What are common barriers and helpful solutions to colorectal cancer screening? A cross-sectional survey to develop intervention content for a planning support tool

Perspectives on cancer screening participation in a highly urbanized region: a Q-methodology study in The Hague, the Netherlands

The role of defensive information processing in population‐based colorectal cancer screening uptake

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