Intentions to undergo primary screening with colonoscopy under the National Cancer Screening Program in Korea

Background We sought to investigate intentions to undergo primary screening with colonoscopy in an attempt to predict future colorectal cancer screening behaviors and the feasibility of implementing colonoscopy as the primary screening modality for colorectal cancer in the National Cancer Screening Program (NCSP) of Korea. Methods Data were obtained from a nationwide online survey conducted in 2018. The survey included a total of 800 eligible adults aged over 45 years. Study measures included the history of screening colonoscopy within the past 10 years and intentions to undergo primary screening with colonoscopy under the NCSP based on the five constructs of the Health Belief Model. Logistic regression analysis was conducted to examine factors associated with intentions to undergo primary screening with colonoscopy. Results Approximately 77% of the participants expressed strong willingness to undergo primary screening with colonoscopy under the NCSP. Higher perceived severity and perceived benefits were significantly associated with stronger intentions to undergo screening with colonoscopy (adjusted odds ratio [aOR], 1.53; 95% confidence interval [CI], 1.10–2.14 and aOR, 2.74; 95% CI, 1.76–4.28, respectively). Greater perceived barriers (aOR, 0.65; 95% CI, 0.45–0.93) were significantly associated with weaker intentions. Cues to action elicited the strongest screening intentions (aOR, 8.28; 95% CI, 5.23–13.12). Conclusion The current study findings highlight the need for increasing awareness of the severity of CRC and the benefits of colonoscopy screening. Family-orientated recommendation strategies and reducing complications may boost an individual’s intentions to undergo colonoscopy.

Predictors of Cancer Detection Behaviors Among Older Nigerian Men

Recent research emerging from Nigeria suggest an increasing mortality due to cancer, especially among older Nigerian men who are at a higher risk of being diagnosed at fatal or advanced stage of cancer. With older age as a significant risk factor for cancer development such as prostate cancer in men, this study explored factors that influence cancer detection behavior among aging Nigerian men. Specifically, we examined possible predictors of current and future intentions to engage in early cancer detection behaviors among Nigerian men. Participants (N=143), with a mean age of 44.73 (SD = 6.15), responded to measures assessing health (cancer detection behaviors), social (masculinity, self-esteem, attachment), and psychological (active coping) factors. Demographic and ecological questions were also included in the survey. Results revealed that education, masculinity, and anxious attachment were significant predictors of current cancer detection behavior. Education, masculinity, and anxious attachment also predicted future cancer screening intentions. We discuss the implication of result for health policy, health education and cancer prevention interventions for Nigerian men and for the global campaign for early cancer detection.

Confusion and Anxiety Following Breast Density Notification: Fact or Fiction?

In the absence of evidence-based screening recommendations for women with dense breasts, it is important to know if breast density notification increases women’s anxiety. This study describes psychological reactions and future screening intentions of women attending a public mammographic screening program in Western Australia. Two-thirds of notified women indicated that knowing their breast density made them feel informed, 21% described feeling anxious, and 23% confused. Of the notified women who reported anxiety, 96% intended to re-screen when due (compared to 91% of all notified women and 93% of controls; p = 0.007 and p < 0.001, respectively). In summary, reported anxiety (following breast density notification) appears to increase women’s intentions for future screening, not the reverse.

A Strategy to Prepare Primary Care Clinicians for Discussing Stopping Cancer Screening With Adults Older Than 75 Years

Background and Objectives Adults older than 75 years are overscreened for cancer, especially those with less than 10-year life expectancy. This study aimed to learn the effects of providing primary care providers (PCPs) with scripts for discussing stopping mammography and colorectal cancer (CRC) screening and with information on patient’s 10-year life expectancy on their patients’ intentions to be screened for these cancers. Research Design and Methods Patient participants, identified via PCP appointment logs, completed a questionnaire pre- and postvisit. Primary care providers were given scripts for discussing stopping screening and information on patient’s 10-year life expectancy before these visits. Primary care providers completed a questionnaire at the end of the study. Patients and PCPs were asked about discussing stopping cancer screening and patient life expectancy. Patient screening intentions (1–15 Likert scale; lower scores suggest lower intentions) were compared pre- and postvisit using the Wilcoxon signed-rank test. Results Ninety patients older than 75 years (47% of eligible patients reached by phone) from 45 PCPs participated. Patient mean age was 80.0 years (SD = 2.9), 43 (48%) were female, and mean life expectancy was 9.7 years (SD = 2.4). Thirty-seven PCPs (12 community-based) completed a questionnaire. Primary care providers found the scripts helpful (32 [89%]) and thought they would use them frequently (29 [81%]). Primary care providers also found patient life expectancy information helpful (35 [97%]). However, only 8 PCPs (22%) reported feeling comfortable discussing patient life expectancy. Patients’ intentions to undergo CRC screening (9.0 [SD = 5.3] to 6.5 [SD = 6.0], p &lt; .0001) and mammography screening (12.9 [SD = 3.0] to 11.7 [SD = 4.9], p = .08) decreased from pre- to postvisit (significantly for CRC). Sixty-three percent of patients (54/86) were interested in discussing life expectancy with their PCP previsit and 56% (47/84) postvisit. Discussion and Implications PCPs found scripts for discussing stopping cancer screening and information on patient life expectancy helpful. Possibly, as a result, their patients older than 75 years had lower intentions of being screened for CRC. Clinical Trials Registration Number NCT03480282

Public awareness of and responses to media coverage of invitation errors in the Breast Screening Programme in England: a cross-sectional population survey

ObjectivesIn May 2018, the British Health Secretary announced the ‘serious failure’ that 450 000 women had missed out on invitations to breast screening in England, leading to extensive media coverage. This study measured public awareness of the story and tested for associated factors (eg, educational level and trust in the National Health Service (NHS)).DesignA computer-assisted face-to-face survey in June 2018.SettingParticipants completed the survey in their homes.ParticipantsMales and females aged 16 years or older in England.Primary and secondary outcome measuresAwareness of aspects of the media coverage and reported statistics. Other data included demographics (eg, ethnicity), awareness of unrelated contemporaneous news stories, trust in participants’ general practitioners (GPs) and the NHS, and (among women) worry about breast cancer and future breast screening intentions.ResultsDescriptive statistics showed that 67% of 1894 participants reported being aware of the media coverage. Regression analyses showed that those who were aware of other news stories, were white British and had a higher level of education or social grade were more likely to be aware. In contrast, only 36% correctly identified at least one of two headline statistics. This study did not find evidence that awareness was negatively associated with trust in participants’ GPs or the NHS, breast cancer worry or future breast cancer screening intentions.ConclusionsAwareness of the breast screening news story was high but recall of reported statistics was much lower: the public may have retained only the gist of quantitative information. Associations between story awareness and attitudes or behaviour were not apparent.