Inequalities in cancer screening participation: examining differences in perceived benefits and barriers

Smith, S.G., McGregor, L.M., Raine, R., Wardle, J., von Wagner, C. and Robb, K.A. (2016) Inequalities in cancer screening participation: examining differences in perceived benefits and barriers. Psycho-Oncology, 25(10), pp. 1168-1174. (doi:10.1002/pon.4195) (PMID:27309861) (PMCID:PMC5082500)

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Abstract

Objective Inequalities exist in colorectal cancer (CRC) screening uptake, with people from lower socioeconomic status backgrounds less likely to participate. Identifying the facilitators and barriers to screening uptake is important to addressing screening disparities. We pooled data from two trials to examine educational differences in psychological constructs related to guaiac Fecal Occult Blood testing (gFOBt). Methods Patients (n = 8,576) registered at seven general practices in England, within 15 years of the eligible age range for screening (45-59.5 years), were invited to complete a questionnaire. Measures included perceived barriers (emotional and practical) and benefits of screening, screening intentions, and participant characteristics including education. Results After data pooling, 2,181 responses were included. People with high school education or no formal education reported higher emotional and practical barriers, and were less likely to definitely intend to participate in screening, compared with university graduates in analyses controlling for study arm and participant characteristics. The belief that one would worry more about colorectal cancer after screening, and concerns about tempting fate were strongly negatively associated with education. In a model including education and participant characteristics, respondents with low emotional barriers, low practical barriers, and high perceived benefits were more likely to definitely intend to take part in screening. Conclusions In this analysis of adults approaching the CRC screening age, there was a consistent effect of education on perceived barriers towards gFOB testing, which could affect screening decision-making. Interventions should target specific barriers to reduce educational disparities in screening uptake and avoid exacerbating inequalities in CRC mortality.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Robb, Dr Kathryn
Authors: Smith, S.G., McGregor, L.M., Raine, R., Wardle, J., von Wagner, C., and Robb, K.A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:Psycho-Oncology
Publisher:John Wiley & Sons Ltd.
ISSN:1057-9249
ISSN (Online):1099-1611
Published Online:16 June 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:Fisrt published in Psycho-Oncology 25(10): 1168-1174
Publisher Policy:Reproduced under a Creative Commons license

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