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

Smith, SG; McGregor, LM; Raine, R; Wardle, J; von Wagner, C; Robb, KA; (2016) Inequalities in cancer screening participation: examining differences in perceived benefits and barriers. Psycho-oncology , 25 (10) pp. 1168-1174. 10.1002/pon.4195. Green open access

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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 2 trials to examine educational differences in psychological constructs related to guaiac fecal occult blood testing. Methods - Patients (n = 8576) registered at 7 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, 2181 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 CRC 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 toward guaiac fecal occult blood 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.

Type: Article
Title: Inequalities in cancer screening participation: examining differences in perceived benefits and barriers
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pon.4195
Publisher version: http://dx.doi.org/10.1002/pon.4195
Language: English
Additional information: © 2016 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology, Social Sciences, Life Sciences & Biomedicine, Oncology, Psychology, Psychology, Multidisciplinary, Social Sciences, Biomedical, Biomedical Social Sciences, cancer, colorectal cancer screening, education, inequalities, oncology, uptake, Factorial Validity, Health Literacy, Older-adults, Information, Invariance, Beliefs, Communication, England, Impact
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Applied Health Research
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1502681
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